Insurance Denial AFTER Surgery??
Hi all, first of all, I went for my 2 week post op visit and was down 14 pounds and everything was great. HOWEVER, I got a processed claim report yesterday that says that I owe the hospital $69,476 - that BCBS didnt pay because "your contract does not allow payment for this particular service". I dont understand? I contacted the insurance company myself and spoke to them prior to surgery and my surgeon's office told me I was approved. So, why is BCBS not paying the hospital? Does anybody have any ideas?? HELP! Thanks!
HW: 337 - Beginning 6 mo pre-op diet: 319 - Consult: 251 - SW:238 - CW: 154 - GW: 160 (LOST 81 lbs during 6 mo pre-op diet)
SURGERY DATE: 10/10/2011
SURGERY DATE: 10/10/2011
I too had BCBS and had the same thing happen- really stressful when you are going through so many changes physically and they add this stress to it----BUT, they did pay everything. It usually happens because something was filed under the wrong number........Mine happened with the Doctors office and anestisia ...............JUST stay CALM (wish someone would of told me that). It will be paid.
I had figured it must be something like that. I emailed my surgeon's office tonite. I'm sure I will hear from them tomorrow. I really havent freaked out....but its kinda hard to rest peacefully until I know for sure. Thank you so much for your reply. It does make me feel better. Have a great evening!
HW: 337 - Beginning 6 mo pre-op diet: 319 - Consult: 251 - SW:238 - CW: 154 - GW: 160 (LOST 81 lbs during 6 mo pre-op diet)
SURGERY DATE: 10/10/2011
SURGERY DATE: 10/10/2011
I would not recommend just ignoring it. It can probably be straightened out with a simple phone call. But bills don't just go away because we ignore them.
Kelly
Please note: I AM NOT A DOCTOR. If you want medical advice, talk to your doctor. Whatever I post, there is probably some surgeon or other health care provider somewhere that disagrees with me. If you want to know what your surgeon thinks, then ask him or her. Check out my blog.
Call the insurance company in the morning. Speak to a supervisor. It could be something really simply, like someone doing data entry put in the wrong code for surgery.
If, when you call they tell you that WLS is not covered on your plan, call your surgeon's office. I assume they received something in writing from the insurance company saying you were approved. Did you get a letter of approval from them?
If, when you call they tell you that WLS is not covered on your plan, call your surgeon's office. I assume they received something in writing from the insurance company saying you were approved. Did you get a letter of approval from them?
Kelly
Please note: I AM NOT A DOCTOR. If you want medical advice, talk to your doctor. Whatever I post, there is probably some surgeon or other health care provider somewhere that disagrees with me. If you want to know what your surgeon thinks, then ask him or her. Check out my blog.
Yeah, dont ever ignore medical bills or denials. It can be something as simple as updating your coordination of benefits info, pre-existing info or something like that. Call your insurance and your surgeon because your surgeon also received or will receive a denial and I am sure they are going to do what they need to do to get paid.
Did you receive an approval letter from BlueCross Blue Shield? That $$ ammount sounds extremely hight as well
LaToya
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Twitter: @ScrogginsFamily
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