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Brasherx2

Gastric Sleeve Patients
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About Brasherx2

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    Newbie

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  • Gender
    Female
  1. Brasherx2

    BCBS AL (PEEHIP) - out of pocket expenses?

    I am so thankful to read your post! I came to this forum to connect with others dealing with the same issues I have encountered with BCBS of AL. I too have been denied for the claim of my 1st month supervised diet visit, my initial bariatric Dr. visit and lab work required by the bariatric surgeon. These three claims total almost $800. I learned from a BCBS customer service rep that these claims were denied because the diagnosis given was "obesity" and my policy does not cover obesity treatment. I took a minute to scratch my head over this news. BCBS clearly defines the steps to take for surgery approval and I am following these steps exactly but it appears I may now be responsible for 100% of the cost of these 7 Dr visits and possible the sleep study because the diagnosis given was obesity. I am now waiting to hear from the insurance coordinator at the surgeons office to review this information with her. I was VERY careful to educate myself on the insurance requirements prior to beginning this process...so this information is shocking. I am completely prepared for the months co-pays($30) and hospital facility co-pay($150) but not for 100% these visits. I would love to hear if/how any fellow bariatric pals may have overcome this obstacle.

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