Denied by bcbs

I spoke to BCBS today, and found out that I was denied. I guess I am going to start the appeal process. I heard that it is good to have your doctor write a letter of how it is not safe for you to wait. Does anyone have a letter like this that I can give my doctor. He said he will write a letter, once he knows what I want him to write. Thank you!

Melissa Why were you denied? I have several letters - they have given me about every reason for denial. Let me know and I can try to help out! Sorry, they are impossible to deal with - I was hoping things would turn out better for you. Let me know what you need. Patty

I was deied because I did not actually see my docter each month of the 12 month diet. I reported to him online weekly. I would appreciate any letters you have. You can e-mail me at [email protected]

Oh Melissa, I'm sorry you've got to fight with these jerks Good luck! Regards and hugs, Ronna

Hi Melissa ... I have BCBS of IL PPO, and was originally denied. It turns out that my COMPANY wanted it excluded, not that BCBS wouldn't cover it. Upon appeal from my surgeon, I was approved (don't know what went on though, whether BCBS had to appeal to my company or what) ... so all I can say, is don't give up!! Please let me know if there's anything else I can do, or feel free to email me. Karyn

Hi Melissa, Welcome to the BCBS denial club. This is quite normal for them to deny you. Just don't give up. first document everything you do and say to them. By the way they are documenting you on the phone verbatim. Find our Why they denied you. Ask for a letter stating the reason, and what it is you have to do to qualify for the surgery. Without knowing the reason for denial how can you appeal. Then you educate yourself as to what a Patients rights are, and read, read, and read your explanation of benefits book from the employer and make sure you are covered. BCBS has a site you can go to so you can learn "insurance terminology". Make sure you use the Disability Act if it applies to you in an appeal. but as the last person answered to your post "first know why you were denied". She is one hundred and 99 percent correct. This is a game you will have to learn. Don't give up, and be your own advocate. Make sure all your Doctors and Surgeons send in letters of recommendation with your appeal. BCBS told me this week they want everything faxed in one neat package. Make sure you get the right department and check that they received your appeal. Any questions ask me. Barb

I wish you all the luck in the world. I ended up getting an attorney to handle it. He just restated everything that was relivant from my medical records and the letters from the surgeon and physicians, etc. At the same time he sent the letter he resent all of my medical records and letters recommending that I have the surgery. It took 2 letters and several months, but they knew that I wasn't going away and that I would go all the way to court if I had to. I was lucky enough to find an attorney to help me for no charge. He would have charged me if we went to court, but luckily it didn't go that far. Good luck and God Bless!