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Old 08-31-2014, 11:28 PM
bwink23 bwink23 is offline
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Join Date: Nov 2013
Posts: 263
Default Anthem BCBS paid 100%, minus co-pay

HI...i got dual neck and back adr surgery covered 100% minus a $550 co-pay by Anthem Blue Cross Blue Shield. My surgery was by Dr. Clavel at Quiron hospital, a preferred provider under them. You can check my posts to see what i did, or PM me if you have questions, i will try to respond.

I kinda-sorta did a pre-authorization, but NOT formally in writing. I checked and made sure my insurance had BlueCard WorldWide, AND that my insurance policy stated that it covered NON-emergency care for covered services outside the country. BCWW gave me a reference number, and even called Quiron for a release of my medical information while i was there, but i opted not to do to give it to them, as i wanted to make copies for me and send them all the necessary paperwork personally.

I sent in all paperwork and supporting documentation and medical records to BlueCard WorldWide. It took them 6 weeks to approve it, but they could not release a check of more than $5,000 to a member, so i had to go through my home base insurance provider, who struggled to get all the information required from Anthem to write the check. I had to give them BCWW service center number, my patient reference number, and some other numbers before they got the information they needed. BlueCard WW keeps all your information on file, and it was MUCH faster for my insurance rep to get documentation from BlueCard WW as opposed to going straight through Anthem BCBS. It was funny, because i could see on my online account i was approved and the amount, but my insurance rep could not LOL.

So, i did have a successful reimbursement at the very least.
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2013 - MRI and CT scan....DDD L4-S1
left side (where my pain is) interarticularis pars fracture/defect with Spondylolithesis L5 over S1 with 2MM anterior displacement

Feb. 2014 - Hybrid lumbar fusion(l5/S1), ADR(L4/L5)...2-level cervical ADR (C5/C6, C6/C7). Dr. Pablo Clavel of Quiron Hospital in Barcelona, Spain. All M6 implants (PEEK cage and plate from Medtronic at fusion level in lumbar.) SAME DAY OPERATION for both areas of the spine.
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