Question:
Did anyone need to appeal for payment AFTER surgery?

Benefits book says it's covered and got my approval letter. Now after surgery, they're fighting me to pay it, saying the surgery procedure code says its experimental or investigational. Dr.'s office says the code is for Open RNY. Help!    — mmepickles (posted on March 1, 2006)

March 1, 2006
CIGNA did something comparable, asserting that the approval letter was for the hospitalization but not for the surgery. It took 14 months of fighting before they paid my surgeon. What helped in the end was the employer whose plan covered me calling CIGNA and demanding that the payment be made. It is maddening. Good luck.
   — SteveColarossi

March 1, 2006
Contact your state's department of insurance and register a complaint. They will investigate the situation with your insurance company. No insurance company wants to deal with the DOI and they usually will just pay the claims.
   — RebeccaP

March 1, 2006
I'm going through a similar situation. Blue Cross Blue Shielf (FEPBLUE) approved me for surgery, when the got the bill, they only wanted to pay 2K, and wanted me to pay the rest. I was freaking out! I contacted a lady at the hospital where I had WLS and she told me not to worry, they would handle everything and that I wouldn't have to pay a penny over the quote they gave me the week before surgery.
   — cdt1334