[LauraB]

Hello Iron,

I was one of the lucky ones who DID get reimbursement from BCBS. I did not get preapproval from my insurance because they don't like the idea that you will leave the states (in my case) to seek healthcare anywhere else; especially a multi-level which was not FDA approved here. I could not have ADR in 2013 due to the multi-level/adjacent to a fusion issue. My only choice was to choose a surgeon elsewhere; otherwise endure multi-level fusion and a restricted lifestyle.
I did go ahead with the surgery anticipating that it would be an out of pocket expense - and yes....I went through my savings, borrowed some money, and sadly sold off some personal possessions. However, my happy thought through all of this was that I would get my life back and enjoy it (priceless!)

My BCBS is through a Chicago Union. I collected all receipts which included a detailed financial statement (in euros and US $) from the surgeon, hospital, and rehab center. I also requested a statement of diagnosis from my surgeon with his surgical notes and opinions. I submitted everything to the BCBS Worldwide network (part of my plan), but they didn't know what to do with it (???) I resubmitted everything directly to our contracted carrier's office. They submitted everything and it took almost a year from the date of surgery to the date I received my check. They covered everything - 100%. How could they not? My actual surgery was a pittance charge for what would have been charged for the surgical intervention here in the states, plus I have a more positive outcome that would not require additional surgery in the future....Saving THEM money! I made sure that I included a letter outlining all of the pre surgical requirements that needed to be fulfilled (therapies, injections, and any other non invasive interventions).

All non-surgical/non-insurance related expenses became a medical tax deduction. My transportation, additional hotel charges, rental car, etc. was submitted and I was able to "eek" back a healthier return too.

I believe persistance is the key with dealing with insurance companies. All too many times they deny claims for absurd reasons - or they made an error. Many people don't bother to question the denial or they make a phone call, but don't get the response they want. I DO! I believe it takes at least 3 phone calls to clear up one little error. Do not give up - perseverance is the key to success. My submission to BCBS was at least 3-4" thick of paperwork - I think I may have scared them away (someone has to read it all).

Good luck to you.
LauraB