Anyone have this problem?
I have BCBS/HMO Blue Choice. I have been told I meet the medically necessary guidelines but they have to verify that there are no updates to my policy that exclude gastric bypass surgery.......what the heck??????? (I have already verified twice that this is a covered procedure and in my certificate booklet it states it is covered if medically necessary.) They are having to request a certificate booklet from their own company (BCBS Human Resources) to verify this. Now if you ask me this just doesn't sound right, or am I wrong?
Confused,
Debbie
Hi Debbie,
E-mail me and I will send you the name and number of the lady that got might all worked out.
[email protected]
Martha
Hi Debbie,
I responded to Ginger's post last night with the following information.
If you have already confirmed that it was covered, and you have documented who you spoke to, etc., and NOW they say it's excluded, I would DEFINITELY call the insurance commissioner's office....
Here's the info from last nights post...
We ALL know that BCBS has paid multiple times this year. There are certain regulatory requirements and notifications that insurance carriers have to make to their customers if they are going to modify or limit their coverage.
I suggest you contact the insurance commissioner's office.
Also, I would let BCBS of Ga KNOW that you are going have contacted the insurance commissioner. NO insurance company wants to have a red flag go up on them at the commissioner's office.
Here is the info...
Website:
gainsurance.org (put www. in front of the address)
Address:
2 Martin Luther King, Jr. Drive
Suite 704, West Tower
Atlanta, Georgia 30334
Phone: (404) 656-2070
Fax: (404) 657-8542
Email: [email protected]
I have BCBS HMO Gwinnett County Schools. I called them after 1 week they said I had been approved, however, they never sent me the approval letter, so I called everday for 2 weeks. Finally they got tired of me calling and sent me my approval. You know what they say, "The sceaky wheel gets the oil." Just start hounding them until they will do any thing to get rid of you.