BCBS won't pay!!!!

I got the statement from BCBS this weekend on my surgeons billing of his fees for my TT and they are not paying. They paid the hernia repair portion of his fees, but not the skin removal. There is no way I can pay these bills coming in. By the time it all adds up, I would have about the same out of pocket to see a regular PS. Matt is upset, because he wanted to have it done. Seeing these bills come in means it will not happen through insurance. I cannot pay this, and now we have only one option left. It never ends does it. I would have never had this done had someone told my insurance would bill me so much. It is thousands. I have one of the best BCBS plans as well. Unbelievable.

Lord knows I hear you! I have a similiar problem with HAP. I got a bill from Henry Ford saying I owe $250.00. I requested an itemized list and cannot find anything regarding this. Henry Ford says it is the admission fee charged by HAP. Excuse me, until I see where they actually billed me, I don't think I'm gonna pay it. IF, I am forced to pay it, guess what? I'll send $1.00 a month... I hope that somehow it works out for you....

Terri.. I thought you had approval from BCBS prior to your TT? Is a panniculectomy covered by your BCBS? I have the specifics that BCBS sets forth in order for it to be covered if you need it (taken directly from the BCBS manual). Try and fight!!!!!! Nicole

I was told it was pre approved and I needed a second opinion which I did get as well. They did not even cover all of the hospital stay. They did bill about $1500.00 total between the crap was not paid. I even received a bill for a doctor that came in to see me(not mine) that insurance will not pay. I'll be damned if I will ever pay that. It was like $250.00. I remember her coming in, but insurance said no way will they pay that. The bill for the surgeons fees was over $3000.00 that they did NOT pay. I received a bill from the anesthesioligist. Not all of that was paid either. I am going to wait until I get the actual bill fromt he surgeon before I make a move. This is all after I received a pre approval. I will fight it, but in the mean time, they can send all of this to collections and ruin my credit even more. I received one bill and the hospital was calling me less than a week later for payment. I neither have the energy nor the motivation to fight this for very long. I have so much other crap to worry about that this is on the bottom of the list. I can easily make all of this go away, and they can all f-off. Sorry if I seem so hostile. Stress can do that to a person.

Geez Terri, that's terrible! Was it all pre-approved before the procedure? Did they just "decide" not to pay it? Mine paid and I have BCBS Community Blue. I hope you can fight them to pay it. Best of luck! Theresa

Terri, Do you get an itemized statement from BCBS? What rejection code are they using? Get me all the details and I will try to help you. If you have a scanner, scan the front and back of BCBS's EOMB and email them to me. I had to write a couple letters to BCBS Traditional when I had my TT so I will try to see if I can help you get the rest paid. They tried to not pay for my anthesia and stuff but they eventually did so we will see if I can help you. [email protected]

I have BC/BS PPO and wasn't even pre-approved and mine all got paid (except my deductible). Sometimes from what BC/BS told me it is the codes that the hospitals bill incorrectly with and they can not pay them until they use the right codes. Anytime I get a statement knowing BC/BS should have paid it I call them and question it and usually they tell me what the billing person did wrong so I can have them bill it correctly and get it paid. Good Luck!

Hey Terri, Chances are it is a coding error. Call your surgeons office and talk to the billing department. They can just rebill with the proper codes. Blue Cross loves to pull this. We see it in our office all the time. I had the same insurance and they paid 100%. Try not to fret to much. I know that is easier said then done. Please keep us posted on what you find out. Good luck ....toni

Drag. I'll keep you in my prayers. kp @ goal