Anyone Won An Appeal With BC/BS of Oregon?

[Billy B]

I am scheduled for a single level Prestige ADR in a couple of days. I have been refused by BC/BS of Oregon for the device, but they will cover the procedure. Has anyone had any luck appealing with them? Or do you know if I am out of luck appealing if I pay for the surgery and try to get reimbursed?

Thanx for any advice!

[Don]

Billy,

There are several people that have had BC/BS pay for there surgery. But, each case is different and each BC/BS seems to have a different attitude about covering ADR.
I have switched to BC/BS this year, because I knew there was no way in hell UHC would cover it but they might. Hopefully you'll get some good responses soon. Keep on searching the archives here and you should be able to PM a few memembers about their insurance battles.

Don

[Terry]

I've had BC/BS Michigan cover my 4 level ADR surgery done at Stenum Hospital in Germany. I am 1 year 8 months out from surgery and bicycling like a maniac and loving/living life.

Best of luck to you.

Terry Newton

[Harrison]

BCBS of Mass. reimbursed me for my ADR, in December of 2004! Sure, I was tenacious, creative and pulled every lever I could. It worked!

I haven't decided yet if I can or will offer appeal support directly patients. Gosh, we know it is needed! What a sad situation for all of us.

[Billy B]

Thanx guys! What's sad is that in the long run it is less expensive for the insurance company and disability. 48 hours to go! Talk to you all on the other side.

[Twiz77]

Billy B - all the best to you! Please let us know how it goes!

Best wishes and prayers for your recovery.

Lisa