MC BCBSil

Yes, you would think that is simple and should be but the amount of work and time is the disappointing part. Thanks for the support and feedback. Cleveland Clinic is handling the appeal. Note when doing my search saw where bcbs is in B$ law suite that is class action. Company once had such a good name is find many ways to try to fatten the bottom line and I guess this is one of them. Frustrating and ruining them as reputable and reliable health care company. I have been with them 30 years. So sad.

Peer to Peer BCBS also denied. Had appointment with primary care and she formulated letter in support with various reasons that stated I met all the criteria required after the peer to peer now waiting on appeal. I have hear that these tend not to go well. Looks like BCBS will avoid meeting their obligations to subscribers. I am so disappointed. I been forced to wait though out this process 1st 6 months of requirements by the Cleveland Clinic (6/4/2023 - November 29, 2023) to get Denied. Then for peer to peer (December 30, 2023) of which I have received nothing in writing about results. Just a email from Cleveland Clinic saying it was again denied. I let them know I wanted the Appeal that they submitted in January and now I will not have a result for another month 2/17/24. In the mean time still getting fatter went to annual appointment primary care 1/8/2023 and it is official BMI 41.2 with high blood pressure, joint issues and overall just not feeling well. OSU primary care wrote letter supporting me having procedure and yet BCBS still continues to make me wait. I was told decision will be available on a Saturday 2/17/2023 and that too seems a little off to me to make decision available on a Saturday. In mean time I am held hostage to this appeal process. I was told by BCBS I could yet appeal again to another outside agency if I am unhappy with their findings. This sucks and this should not be the health care insurance companies treat not just their insured clients but the hospital that support their plans. This is so out of wack. If somone qualifies for treatment by their provider (my doctors) and through the terms of my health care policy (BCBS) I should not have to go through this mountain of red tape and still yet possible be denied the care in which I pay for every month. This sucks.

Peer to Peer BCBS also denied. Had appointment with primary care and she formulated letter in support with various reasons that stated I met all the criteria required after the peer to peer now waiting on appeal. I have hear that these tend not to go well. Looks like BCBS will avoid meeting their obligations to subscribers. I am so disappointed. I been forced to wait though out this process 1st 6 months of requirements by the Cleveland Clinic (6/4/2023 - November 29, 2023) to get Denied. Then for peer to peer (December 30, 2023) of which I have received nothing in writing about results. Just a email from Cleveland Clinic saying it was again denied. I let them know I wanted the Appeal that they submitted in January and now I will not have a result for another month 2/17/24. In the mean time still getting fatter went to annual appointment primary care 1/8/2023 and it is official BMI 41.2 with high blood pressure, joint issues and overall just not feeling well. OSU primary care wrote letter supporting me having procedure and yet BCBS still continues to make me wait. I was told decision will be available on a Saturday 2/17/2023 and that too seems a little off to me to make decision available on a Saturday. In mean time I am held hostage to this appeal process. I was told by BCBS I could yet appeal again to another outside agency if I am unhappy with their findings. This sucks and this should not be the health care insurance companies treat not just their insured clients but the hospital that support their plans. This is so out of wack. If somone qualifies for treatment by their provider (my doctors) and through the terms of my health care policy (BCBS) I should not have to go through this mountain of red tape and still yet possible be denied the care in which I pay for every month. This sucks.

Shopping around. Agree about the discrimination and or selectiveness of what constitutes health procedures. The track records speak for themselves. Hopefully someone pays attention to outcomes. Results should matter. If you pay for insurance you should not be brined coverage for proven health related procedures ever. That is why it is called health insurance but I agree that they want to keep you sick. Maybe they should call it sick and dying insurance. So sad so backwards.

I was denied. Tomorrow is peer to peer review. It that is denied again I am going to appeal for the record to be official for the process of tracking these denials. I have been on this plan and expected my insurance to cover my recommended treatments. I could hardly believe it was denied. Feel very violated and taken advantage of by the company I pay every month for coverage