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  #11  
Old 12-29-2013, 10:18 PM
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jasonhhh jasonhhh is offline
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Quote:
Originally Posted by 2Confused View Post
Congrats Jason!!

I recovered 60% from BCBS after cervical surgery with Dr. Clavel. Am I reading correctly that you received 100% coverage from BCBS? That is wonderful!
yes I was covered 100 percent also dr clavel was in network so was hospital oh I also have a ppo plan
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  #12  
Old 12-30-2013, 04:16 PM
FranklySir FranklySir is offline
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Hey Jason,
Congrats on reimbursement and hopefully a succesful surgery.

I have my documents in right now and awaiting there determination. Filed exaclty as you and was toldthey were doing an audit on the claim last week for my double cervical in June. News to come hopefully.

Just got back last night from a double lumbar done one on December 18 so this should get real interesting.

Can you tell me where you found that Clavel was in Network?

I would appreciate it. Thanks Frank
__________________
Lumbar issues 18 yrs
herniations lumbar L3-5 multiple Epis etc etc
Annular tears L3-5 cauda equina
Cervical herniation symptoms 2011
C5-7 M6C by Dr Clavel on June 5 2013
L3-5 M6L by Dr. Clavel on 12.18.13
Living life instead of living the condition
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  #13  
Old 12-30-2013, 06:17 PM
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jasonhhh jasonhhh is offline
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Quote:
Originally Posted by FranklySir View Post
Hey Jason,
Congrats on reimbursement and hopefully a succesful surgery.

I have my documents in right now and awaiting there determination. Filed exaclty as you and was toldthey were doing an audit on the claim last week for my double cervical in June. News to come hopefully.

Just got back last night from a double lumbar done one on December 18 so this should get real interesting.

Can you tell me where you found that Clavel was in Network?

I would appreciate it. Thanks Frank
yea im 3 months post op 2 level lumbar, I believe Yolanda told me over the phone when I called up I asked if they accepted my insurance and also if the hospital did she said yes
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  #14  
Old 12-30-2013, 09:00 PM
2Confused 2Confused is offline
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Frankly,
I found them listed on the WORLDWIDE BLUE website.
Good luck!
Quote:
Originally Posted by FranklySir View Post
Hey Jason,
Congrats on reimbursement and hopefully a succesful surgery.

I have my documents in right now and awaiting there determination. Filed exaclty as you and was toldthey were doing an audit on the claim last week for my double cervical in June. News to come hopefully.

Just got back last night from a double lumbar done one on December 18 so this should get real interesting.

Can you tell me where you found that Clavel was in Network?

I would appreciate it. Thanks Frank
__________________
50 year old female
Rear-Ended in 2009
Disk rupture cervical 5-6 & 6-7
2 level M6 ADR, Dr. Clavel - Oct. 2012
Insurance paid
Not a day goes by that without me whispering a silent "thank you" to Dr. Clavel
Post Op 2+ years
Cross Fit 3-5 times a week
Running 5ks
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  #15  
Old 02-27-2014, 05:43 PM
FranklySir FranklySir is offline
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Well All,

Not sure if you had seen my post but I too got reimbursed 100% for my Cervical 2 level.

Just about to put in for the Lumbar claim.
I think it has alot to do with or all to do with Quiron Hospital is a preferred provider for BCBS WW and considered in network. I think what is happening is that the ice has been cracked and there is recognition that Clavel is accepted as in network. I have also seen more people going to Germany getting paid as well.
It is sad however that as US citizens we cannot without alot of stink have choices. Remember we still all paid a bunch of duckets to fly and hotel as well.
Lumbar was no joke so visiting really wasn't any picknick walking around in Spain. The other unfortunate thing is the really calous nature of many (not all) of our Doctors here. Hold on this ride is gonna be rough cause its gonna get worse.

Ill keep up to date on the lumbar claim. Go's in tomorrow.

F
__________________
Lumbar issues 18 yrs
herniations lumbar L3-5 multiple Epis etc etc
Annular tears L3-5 cauda equina
Cervical herniation symptoms 2011
C5-7 M6C by Dr Clavel on June 5 2013
L3-5 M6L by Dr. Clavel on 12.18.13
Living life instead of living the condition
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  #16  
Old 02-27-2014, 09:36 PM
bwink23 bwink23 is offline
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Join Date: Nov 2013
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Frank,


BlueCard WW actually called Quiron to get blood tests and medical reports directly. I was not aware they would do that. I think they were trying to expedite the claim. My info could not be released since I did not sign any release forms. I told Yolanda to tell them if they called back that I would be submitting the info personally. I could have had it done directly, but I wanted to insure getting copies of all paperwork exchanged for my records. How long did you wait for the email with the itemized billing?
__________________
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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  #17  
Old 02-27-2014, 09:52 PM
FranklySir FranklySir is offline
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B,

First, I hope you are doing well!!!
Took about 3-4 weeks from memory. It takes time for them to get it all put together unfortunately and then it needs to be put in english. Make sure you also get a Letter of medical necessity.
It sounds like your gonna be OK with being reimbursed. The only costs they took out were Hotel and the added insurance if you bought it. I was only 200$ copay. Dot your I's and cross T's. My only concern for you is that I think you said you have a PPO. It might cut it but then again others it did not.

Frank
__________________
Lumbar issues 18 yrs
herniations lumbar L3-5 multiple Epis etc etc
Annular tears L3-5 cauda equina
Cervical herniation symptoms 2011
C5-7 M6C by Dr Clavel on June 5 2013
L3-5 M6L by Dr. Clavel on 12.18.13
Living life instead of living the condition
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  #18  
Old 02-27-2014, 10:28 PM
bwink23 bwink23 is offline
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Join Date: Nov 2013
Posts: 262
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My plan is a PPO for care within the United States. Not sure how they handle claims outside the U S. I'm gonna push for in-network benefits citing Quiron being listed as a preferred provider. My insurance covers at 90% for in-network....out of network covers at 70%. Even if I got reimbursed at an out of network rate, it's better than nothing at all. I'm hoping me contacting them ahead of surgery helps. I believe poster Jasonhhh also had PPO with BCBS.. he got 100%. It depends how your policy reads. All I know is I verified coverage with home base and BCWW. We'll see. What type of BCBS policy u have?
__________________
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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  #19  
Old 02-27-2014, 10:39 PM
bwink23 bwink23 is offline
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Join Date: Nov 2013
Posts: 262
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I contacted BlueCard Worldwide. They said I was covered, as did my home policy...I verified that nonemergency care was covered and I w as planning spinal surgery.. Some people depending on policy are only covered for emergency care or doctor visits when traveling, not scheduled surgeries. It's important for BCBS members verify what is covered before planning expensive surgeries. I have not had any reps say I had no coverage. They did say I may only get a 70% rate. Fingers will be crossed when I mail the paperwork.
__________________
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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  #20  
Old 04-17-2014, 10:03 PM
2Confused 2Confused is offline
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Join Date: Jun 2011
Posts: 322
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Hi all!
I love hearing that some are getting 100% reimbursed! Should I request my 40%? LoL just kidding, I was thrilled to get the 69% paid for.

News about me---still feeling awesome! Just got back from hiking and some very junior rock climbing in AZ. My disc held up well and I had no pain! I count my blessings everyday for the M6 and Dr. Clavel. I'm doing Pilates 2 times a week, walking almost daily with some jogging mixed in. I feel better than I have felt in years and since my injury was accident related I take NOTHING for granted. I hope everyone else is doing well too!
__________________
50 year old female
Rear-Ended in 2009
Disk rupture cervical 5-6 & 6-7
2 level M6 ADR, Dr. Clavel - Oct. 2012
Insurance paid
Not a day goes by that without me whispering a silent "thank you" to Dr. Clavel
Post Op 2+ years
Cross Fit 3-5 times a week
Running 5ks
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