- HEALTH TRACKER
does anyone w/ bcbs/fl have this problem?
I just got my ins. aug.1 this yr. I went to my 1st. visit aug.19 just for check up then they took lab work etc... and she did tell me i have to loose weight and told me to go on 1800 cal. diet and exercise I just got an explaination of benefits in the mail today and said i have to pay for the visit i called bcbs cust. service and she said my pcp put the claim in under adult wellness code and that was right but the diognose was wrong the pcp put that under obesity she said tell my pcp to put it under something else cause they dont cover obesity should she put it under morbid obesity or under what she is treating me for only high blood pressure etc...?thank you if u know or have simular problem, also I went to 1st. consult 2 weeks ago is the ins. going to cover that? Any answers will b appreciated,Ps. what about the physc. evaluation they told me on the phone i only have to pay co-payment but r they going to charge me 4 that also? thanx in advance 4 any help. — Kelliann S. (posted on October 2, 2002)
October 2, 2002
Hi. I dont have bc/bs FLA, but I do have bc/bs. I had the same problem. My pcp used the diagnostic code morbid obesity and they refused payment. She had to change it to something else. Your Dr might need to do that also. After my surgery was approved, the hospital used that diagnostic code (morbid obesity) for my pre op tests. They were originally denied as well, but when I called my insurance they found my authorization for surgery and then they covered everything. My psych eval was covered also.
October 2, 2002
Just a word of warning - I heard BCBS FL isn't going to be covering any WLS regardless of morbid obesity under any circumstances. I'm not sure if this has started already or begins January 1, 2003, but please call and check on your own policy.
October 3, 2002
I had the same problem with BC/BS and I think I am going to ask my doc to resubmit the bill. With all the co-pays, educational fees and time off of work, I cannot afford another $75 for my doctor. Besides, it seems like an easy enough thing for them to do. As far as the other bills, my psychiatrist wasn't covered ($140 out of my pocket) and I got a bill for .55 for what they didn't cover of my lab work.
— Mrs. Rich