Won my Appeal with BCBS-TX Now TBI Drops BCBS
 

So after months of dealing with BCBS of Texas, I won my appeal to have a one level lumbar covered. While I was planning on my surgery in the October time frame, I received a letter and a phone call indicating Dr. Guyer (and presumably Texas back Institute) would be dropping BCBS because they don't pay enough. Therefore, I would need to have my surgery before August 1 (When in fact they actually cut ties with BCBS). So all of my post surgery care would now be out of network. I was told I was the second to win a BCBS appeal so how can they be losing money?

I made an appointment with Dr. Guyer for a follow-up consultation and to get some further info. After waiting in the office for 45 minutes without a peep from the staff or doctor, I walked out. TBI does not have a quality staff and the doctors truly do not care about their patients. This might be a general statement, but I have never waited less then 45 minutes for any of my appointments, have to call and email 2 or 3 times to get an answer from the staff.

Through conservative measures I have gotten my back to a point where surgery is not immediately needed, but will be in the future.

Take this with a grain of salt...... May not be reflective of all patients, but it is reflective of my care under Guyer and TBI.

-- Jim

Bcbs
 

I had Aetna before, and had a choice of BCBS or Aetna, seems now I made a bad Choice.

The Aetna I had before was a HDHP with an HSA.

I am sure that I will have to have a lot of resolve to get this covered by BCBS.

People are dropping them like FLIES.

This is ridiculous, if you have the pain and history, then why not just pay for the ADR.

By the time they hem and haw, make you take a bunch of tests and BS, they will have spent DOUBLE what it would cost for the ADR.

Not to mention that they are causing a bunch of pain.

that be it
 

Amen brother!!!!!!!!

I got a one level ADR approved by BC/BS OF OHIO. Although, they paid kicking and screaming. I had to file a first level, second level and at the external level they approved it. I don't know why they didn't approve it .. they only paid 35,000 of 155,000 AND THAT'S WHY PROVIDERS ARE DROPPING THEM. They pay a small protracted fee of the superbill so I don't understand why they put up a big fight. BC/BS are a buch of lying ……. LOL . They are crooked and made billions in profit last year by denying our care!!:insane:

Don't give up!
Tammi:angel: