BC/BS Federal does NOT pre-certify - 10 days before surgery. What to do?

cynthiabowes
on 12/30/05 1:22 am - Juneau, AK
Can anyone advise me on this? I am to have my surgery 9 January. Yesterday I found out that BC/BS does not pre-certify the doctors. They could not assure me that this portion will be paid, meaning I have to go into an expensive surgery uncertain that a major portion of it will be paid! * Can anyone who has dealt with BC/BS Federal advise me as to whether or not they did indeed GET PAID? (My justification letter/test results are "good" for the RYN, so that should not be any problem.) * Should I proceed with the surgery and take a chance? Thanking you in advance, Cynthia Bowes [email protected]
Jer
on 12/30/05 6:50 am - Milwaukie, OR
I have Federal BC/BS ( as a postal employee ) , and had my surgery July 25, 2005. My doctor did all the paperwork and got pre approval for the surgery. Since it was pre approved and at a preferred provider hospital and a preferred provider doctor, all my lap RNY cost me was $100. BC/BS covered the rest of the cost which was over $23,000. Now, unless it has changed for 2006 ( haven't checked my new booklet on that) you should be able to get preapproved for the surgery. Of course it helps if you have other medical problems too like diabetes, high blood pressure, or sleep apnea. This surgery cured all 3 in me plus no more aching knees. Jer
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