BCBS FEP in TX and very confused, need help ASAP.

wanting2Bthn
on 11/30/09 9:23 am - TX
Ok, so I have BCBS FEP and live in Texas does this mean that I must go to a designated "blue award winning" bariatric hospital or pay out-of-pocket/network fees?  If I choose a doctor that is in network and a hospital that is also in network shouldn't that be enough?  I'm so confused with the whole process, any help will be greatly appreciated.  Did I fail to mention I am also just starting the whole process of getting an approval.  I'm scheduled to go to a seminar in Jan. for more info. but I would like someone who has "been there done that" or just has expert knowledge in this matter.  

Best Wishes to All waiting on Approvals!!
Virgie Tschirhart
on 12/3/09 3:49 am - Midwest City, OK
RNY on 12/27/17

Hi wanting2Bthn,

Honey, I have BCBS FEP I live in Oklahoma City.  I went with an out of network doctor for my VSG.  Because I was told BCBS FEP would not cover the VSG, so I went with the doctor that I liked.   I was cash pay.  Although I went with a doctor out of network and the hospital too was out of network, I still got reimbursed for some to the charges.  I'm in the middle of appealing to OPM as we speak.  I want to get the whole amount reimbursed, I have read here on this website many other BCBS Fed got 100% coverage on their VSGs. 

Best wishes to you too Darlin.

blessings
babygirlinokc


Virgie Tschirhart

Lap Band - 2008, Sleeve - 2009, RYN - 2017

Started Program Weight July 13, 2017 - 194.2

Before Surgery Weight December 27, 2017 - 185.0

Current Weight - February 2018 - 161.0

wanting2Bthn
on 12/3/09 5:51 am - TX
Thanks for the words of encouragement!!  The whole insurance thing is sooo confusing.  Good Luck to you on getting your money back but also Congrats on taking in it on yourself and getting sleeved. 
Jesse_James
on 12/3/09 12:34 pm
What's OPM and the basis of your appeal?

loose -- (adj)  not tight
lose - (verb)  to rid oneself of

  
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