Brink,
Yes, I have Worldwide Blue with my BCBS Policy. To be honest I did not know this until I started researching and reading my policy prior to making the decision to go to Spain for surgery. My suggestion would be research your policy to determine if you have WWB. I must assume that it would depend on the type policy one has as to whether WWB is included in their coverage.
I did not seek pre-authorization, nor did I go through the appeal process.
Upon my return from Spain I gathered all the documentation to be sent for my claim and sent it by certified mail to WWB. About 6-8 weeks later we received a letter from BCBS saying my claim was being reviewed. ( we fully expected a denial to arrive soon after) however, A couple of weeks later we received a check in the mail.
I really cannot explain
why BCBS paid for my procedure but denies other claims.
I might add I had documentation for over three years of doctor visits, treatments, physical theraphy, a letter of medical necessity from both my NeuroSugeon and Dr. Clavel. All of this was included in the package sent to WWB, with a cover letter CC'd to my attorney.
We also included the following in the cover letter "the procedure performed is not experimental in the country where surgery was performed".
Hope this helps.
Frankly,
Glad to hear you are recovering nicely!! Walking 20 miles? Wow!! Impressive.
Quote:
Originally Posted by bwink23
2Confused....you did say before that you have a WorldWideBlue coverage plan correct? Do you know if this a paid-portion of your coverage, or should most people who have BCBS contact them first before approaching procedure?
Do you know if you PAY for WWBlue or not?
Plus, did you get pre-authorization, or appeal a reinbursement?
Your case could prove invaluable for those seeking coverage thru BCBS. If you have time, i would suggest posting how you went about the process.
I've read that Dr. Clavel is U.S. board certified, this could also play a role in the quest for reminbursement.
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