Re: Re: BCBS Troubles (Stormy)

[Guest guest]

In a message dated 9/21/2000 11:52:09 PM Eastern Daylight Time,

tartboys@... writes:

<< When I first joined the list and started talking to my husband and others

about Kristi and Gloria and Cathy and Lara and everybody else, sometimes he

would say, now are these people that you know in " real life " or are you

talking about your " internet friends " . I think finally he is learning who

is who!

Thanks again for all your help! I apoligize for not getting back to you

sooner but it is always hectic around here!!!

Dana Tart >>

That is how I feel. It is so funny, one evening I was feeling kind of

depressed a while back and I told my husband that i was going to go get on

line to see how my friends were doing. it must have been a weekend because i

remember i got on and there had been no posting (I had probably checked only

a half hour before) LOL lOL anyway I came back into to the living room and

Jim said what's wrong honey weren't your friends there and I remember

thinking how sweet i thought it was that he realized that i thought of all of

you as my friends. Sorry to jump in your post Dana, it just made me remember

that. You guys have helped me keep my chin up and keep looking forward!!

Thanks!!!

Cathy Morrow in Lenoir, NC

BMI 42

A journey of a thousand miles begins with a single step

[Guest guest]

Stormy

Thanks for sending me all the great suggestions! I think it is so great

when the people on here reach out to help each other. This is truly what the

list is made for!! Isn't it funny to think we were all strangers before we

stumbled on to this list!!

When I first joined the list and started talking to my husband and others

about Kristi and Gloria and Cathy and Lara and everybody else, sometimes he

would say, now are these people that you know in " real life " or are you

talking about your " internet friends " . I think finally he is learning who

is who!

Thanks again for all your help! I apoligize for not getting back to you

sooner but it is always hectic around here!!!

Dana Tart

Re: BCBS Troubles

> Hi. I also have Blue Cross, but it is a PPO type. I was denied twice

> before I was finally given approval, and even then, it took a phone

> call from a lawyer to the Doctor who does the approval to get mine

> approved the third appeal. They are very difficult, but your problem

> is most likely that you have not yet gotten the right person on the

> phone. By that, I mean that some people are MUCH more helpful in

> telling you exactly what they need in in order to get an approval. I

> am wondering if you could get your PCP to go to bat for you with Blue

> Cross rather than Dr. R.? Since your PCP is doing the bulk of your

> physical, he or she should be able to call Blue Cross for you.

> Usually, it is just a matter of giving the insurance company what

> they want. It is unreasonable for them to ask a physician to call

> them, anyway. Many physicians refuse to call because they have sent

> all of your medical information, and that is all the insurance

> company needs in order to do an approval. You also might want to try

> faxing your insurance company and explaining your situation. Tell

> them that your PCP did your physical and Dr. Rutledge did your

> sugical consult based on the RECOMMENDATION of your PCP. Explain to

> them that you have provided all of the required paperwork, such as a

> copy of the clinical notes(my company wanted clinical notes of my

> physical even though they would not tell me that)as well as the

> paperwork from your surgical consult. At least with email, you will

> have a clear, written response from them explaining their position.

> They are just trying to frustrate you enough to run you off. YOU PAY

> THEM, and if this is a covered benifit, they HAVE to pay if you meet

> the the requirements for surgery. Please don't give up!

>

> Stormy in Alabama MGB 8/11/00

>

>

> > Hi Everyone!!

> >

> > I am having trouble getting BCBS to approve the surgery for me! I

> > don't have the state employees policy, we have an HMO.

> >

> > Has anyone recently dealt with BCBS and been approved? They keep

> > telling me they need more information from Dr. R's clinic visit.

> > Barbara from Dr. R's office sent them a copy of the clinic visit

> > paperwork and they are still not satisfied! They want to talk

> > directly to him!!

> >

> > I e-mailed Dr. R last week and he told me he had done all he was

> > willing to do with BCBS on my behalf. Although I am disappointed I

> > understand where he is coming from.

> >

> > Has anyone got any suggestions? I wrote and faxed an appeal letter

> > today- for all the good that will do. I am just about to give up

> > hope!! I have done all I know to do!!

> >

> > So if anyone out there has any ideas please contact me! Big Red is

> > in the same boat with me and she has helped tremendously!!

> >

> > I had a ball at Cattlemans last night- even if we were an hour

> > late!! Everyone was so nice!! Good luck to all who are having

> > surgery this week!!!!

> >

> > Dana Tart

>

>

>