Latest Letter from BCBS

Ya, so they obviously didn't read their own records to see they denied me.

Sent me a letter regarding my July 8th surgery and post operative care and discharge plan, with an outline of after care benefits.

GEESH! Idiots!

I think I'll write a lovely response to them and include their letter in my 2nd appeal packet. ha!

Sounds like they have approved you, or at least expect to.  Keep writing and I would definetely send them a copy of that letter, and make a statement how they are playing with your emotions...

 

Just my 2 cents

Well, when my 300 some page 2nd appeal goes in, they may look at that book & decide just to approve me based on the fact my appeal is a book - they probably don't anticipate appeals going this far. I haven't a clue as I can't get in their brains, but here's hoping!!!

I've been doing a lot of research to help put this second level appeal in so hopefully we will come out victorious at the end. I believe we only get 3 tries and I pray it doesn't go that far.

Thank you for stating the emotional part. I really was finding the letter somewhat humorous but it still stung to read it and remember the date I had hoped so hard for had come & gone.

TY Paul!

Not just write... but call!!!!! this is getting rediculous!! And yes, do as Paul says... let them know what this is doing to your emotional state........

I will definitely call at 8 a.m. on Monday, thanks Diane!

Blue cross blue schield was my carrier when I had my surgrey. I waited a week after my letter was submitted, and started calling every few days.... I knew every step of the way what was happening..... sometimes we have to be a bit agressive right!!!!!

Good Luck... your a fighter, and you have fought this long, and this hard... You have to come out on top.

Sounds like one hand doesnt know what the others doing... idiots..yup I would write.   Makes you feel like someone was rushing off to lunch and just stamped denied on your paperwork...

IDIOTS

LOL @ rushing off to lunch...geesh, I hope not! I wonder if you can inquire as to the process taken in their review and how they came to their decision to deny? hmmmm...

Hmmmm- I might work for that company??   

Rest assured that we are not all idots, at least not me I work in contracting. I am pretty sure  that a person didn't send you the  letter it was probably system generated and the computer system that sends the letter didn't see a denial...I think that is probably a good thing, your case is open because they are working on the appeal.

Writing is fine but you will get much results much faster if you call.  Have your letter ready to fax in if necessary. Call customer service, tell them you got  the letter and ask if you can speak to the nurse who is handling your appeal- because you think there has been a problem or that she could well be an idiot.  If they won't let you speak to the nurse, then ask for a manager.

They  really do try to make a healthy difference in people's lives you know....so they will listen to you.

Good Luck!

 

I am sorry to offend your employer, but when they tell me that I'm not fat enough or unhealthy enough to have an "investigational" surgery (of which I have researched the heck out of and decided was the correct surgery for ME and know it is NOT an investigational surgery), system generated or not, I have a right to be a little miffed.

I do sincerely appreciate your response and will take your advice and make the call on Monday. Thank you for that advice!!!