Any secrets to submitting PMRI receipts to your insurance carrier?

Hi, I noticed this topic comes up from time to time and since I am currently in the midst of trying to get my insurance claims under control...I thought I'd ask a question... I've been submitting my receipts for PMRI appts ( both pre-op and post-op) to my insurance carrier which is BCBS Personal Choice PPO. I get what seems to be a different answer from whatever BCBS rep I speak to each time I call them with questions. In general, I've been successful with getting reimbursed BUT -- WHAT AN ORDEAL! I am still trying to clarify ones that go back to last year! For some reason, sending them the receipt PMRI provides with a BCBS claim form is often not enough. Sometimes, BCBS declines it multiple times -- my all time tops, 10 times! -- because it is "missing" provider codes, diagnosis codes, etc. etc. I am getting weary of this process and wondering if there is some secret to sending in the receipts and getting them accepted the 1st time? I am so tired having to make multiple phone calls and go over and over and over...I am happy when I finally do get reimbursed but I would LOVE it if I knew how others do it...and if they found any "secrets" to making it easier? THANKS, Kit

Hi Kit, No real secrets that I can think of. I have a different version of BCBS than you do and I've had a problem or two but nothing like you describe. I have had to send back once or twice due to code errors but that's about it. What a pain! Linda

Hey there Linda, Thanks for your input. I think the most frustrating things are that every time I call BCBS with a question I get a different answer depending on who I speak to. I think that might also have something to do with the speed my claims (do or do not) get through...I mean some reps are "pickier" than others. The real pain is when it has a problem they can only deal with one issue at a time...so if they reject it because it is missing the provider code...that's one...then it comes back to me needing the procedure code...that's two...then....well, anyway, even the BCBS reps admit it's stupid that they can't point out all the missing info in one time around...oh well, I'll just keep plugging away...keep good records of what I have or haven't gotten... and hope for the best! THANKS, Kit