I just want insurance info from BC/BS Federal!

Ok, when I had my initial surgery, I was self pay because the insurance I had then specifically excluded any WLS.

I have new insurance and want a revision. I call customer service to check the benefits. Customer service tells me to call precert. Pre cert tells me to call customer service because pre cert is for doctors office.

Call customer service back and they say...must be 18, have a bmi of 40 or more...blah, blah, blah. We all know this already.

I start asking other questions and they say they cant give me any answers, they just have to put the code in and tell me the outcome.

The revisional surgery people say its my responsibility to call my insurance and make sure everything is covered.

WTF????????

Ok, Im done, but Im getting some kind of damn answer today. I want this band OUT!

Well, I tried a little harder and I guess I got all upset for nothing.

The doctors office had the list of surgical codes online and I was able to call insurance and give them the numbers, they are both covered surgeries....

CPT CODE 43844, Lap Gastric Bypass

CPT CODE 43845, Biliopancreatic Diversion with Duodenal Switch

 

awesome, I am so glad that you found out that your insurance covers your surgery.  I bet you are supper excited to get that band out!!

I have BC/BS federal too. They told me over the phone it would all be covered but then when the doctor submitted it, it was denied. It took me 7 months to get them to take my band out and it's now 7 more months fighting them to do the revision. Not to discourage you but the phone calls are often taken by a different provider than the insurer who processes the claims. Just make sure your doctor submits and gets the pre-cert in writing.

Britt

Thanks Britt. Hope you get everything worked out. That must be agony.

Yeah, all I know is that they cover the surgery. No idea if they will cover it for ME or if they will cover a revision.

Im hoping that the new office will call me to setup an appt today.

OMG, I had the exact same experience with Anthem BlueCross PPO for CalPers. They kept sending me back and forth. I did this like 4 times then figured out that it really just seems better to have the physician submit after you tell them you will consider self-pay anyway; otherwise, they don't seem to want to see you.