B/C BS FL

I had RnY on 5/25/04. Naturally I jumped through all the hoops BC BS puts us through. I have their letter saying weight loss surgery is a covered procedure. Guess what, I have recieved my EOB from BC BS telling me the $26,000.00 for my surgery is my responsibility that it is not a covered expense. Also the $1,500.00 charge for anesthesia is not a covered expense...Naturally I am going to appeal this. Has it happened to any other BC BS FL (PPO) people out there? If so, do you have any words of wisdom for me in dealing with this..I can't believe it. Please let me hear from anyone who has information or experience with this. Thanks, Molly

Woah! That's insane! Did your Dr get the approval letter and number? If so get a copy of it and call the isurance comp and see what's up. I have BCBS and had to pay about $2200 to the hospital and 245 for anesthesiologist. I havent gotten the surgeon bill part yet but I guess it'll be about $1600 more? Sorry for your troubles! Christina

Welcome to the wonderful world of BC/BS who is world-famous for not paying or paying very slowly and making everyone concerned miserable along the way. You'll get it straightened out, but you'll have to fight to do it and for that I'm sorry! Pre-Op Jan

I have BC/BS FL ppo Federal and I had to get pre-authorization for my revision surgery. I was told that they were giving pre-authorization (after submission of paperwork by Dr.'s office) starting January 1, 2004 (this year). Prior to that date they did not doing pre-authorizations. Even my doctor's office insurance person did not know about this and as soon as I told her she submitted my paperwork and I got my pre-authorization for my surgery prior to actually having the surgery. Susan

I had the same problem last year. Mine was solved very simply by having all the providers attach a copy of the BCBS letter to you. Until that is done, they will not pay.

Same crap here. Got a bill from the hospital for 45,000 that BC/BS was not going to pay. Here we are a year later and I am still fighting with them. But they will pay. Sent in copies of the approval letter to me, to the doctor and still they are procrastinating. BC/BS is horrible with any kind of surgical payments, not just Gastric Bypass. Good Luck!! Smooches, Gigi

I do not want to hear this! I was told, my co-pay to doctor would be $800. They could not give me amount to hospital. Would depend on length of stay and etc. I am broke! If for some reason they do not pay, $10. per month to each, hospital and etc...... Marla