BCBS WW - Process
 

Dear All,

Just finished filling out the claim form for the overseas ADR with BCBS WW. However, before I get the ball rolling and send this thing in, I figured I needed to get my ducks in a row and get educated.

I need to get a copy of the "playbook" (rhetorically speaking!!) so that I can "DIRT FT" (Do It Right The First Time).

If anyone would be so kind as to guide me through the process, what I should supply them with and what I should avoid at this stage. What to expect, etc. etc.

Also, I figured I will need to begin putting together my case, with all sorts of back up materials, etc.

Any help is appreciated.

Dave

Get ready, I did all the Pre stuff, fought them tooth and nail, even paid for for the material for an appeal.
No luck.
Went to Germany, paid for it, and when I came back submitted the reimbursement.
They paid their portion of the hospital bill, but are only paying a small portion of the surgeon's fees, they claim they were out of the network, and the amount was beyond my allowed amount.
What is 'allowed'?
So, I am fighting the surgeon fee, and make sure you can document what you did, what type of procedure, and try to give some amounts in US equivalent, such as an adr here might be $50K US and over there it might be $30K, or something.
Be prepared, they most likely will not pay.
But you can take all of this on your taxes.
I am not sure, if you can spread this over more than one year, but most of us do not make enough to absorb all the expenses, but EVERYTHING is deductible.
Good Luck.