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Re: JJ BCBS

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JJ,

Just want to mention that I asked the insurance co.

for a list of the in network doctors who did this

surgery and called them all. When I finished I called

the ins. coordinator back and told them that none of

the Doctors on their list did the surgery. This is

how I got BCBS of MI to approve me out of network.

Hope this helps

B

--- jjamineteoj@... wrote:

> I know a lot of you here are interested in BCBS

> approvals....I have

> BCBS Vermont. I applied for prior approval for

> BPD/DS with Dr. Hess

> two weeks ago, and......

>

> It just came back approved, that's the " good news " .

>

> The " bad news " is that they approved it at standard

> benefit levels,

> which leaves me with a 30% co-pay and a $500

> deductible, on top of

> the $2500 that Hess asks for.

>

> Their reasoning was that the procedure was available

> in network. It

> isn't, believe me, I've looked. I suspect it's

> going to be the old

> RNY argument, will know more shortly.

>

> So now I have to convince them of the benefits of

> the " Long Limb RNY "

> vs. the standard RNY.....this after I FRIGGING

> SPELLED IT OUT FOR

> THEM, COMPLETE WITH DIAGRAMS in my original request.

>

> Ahh, if it was easy, everyone would do it....

>

> jj

>

>

>

----------------------------------------------------------------------

>

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