In January, I called my insurance company and asked if WLS was covered. I was told yes as long as I met the criteria - co-morbidities, psych eval, meetings with nutritionist, 5 years or more over 100lbs overweight, bmi, etc. I did what I was supposed to do and received the approval from the insurance company and 3 weeks later had my surgery. Last week, I received a statement from BCBSNC showing claims submitted and subsequently DENIED for costs of over $100K. They denied the surgeon's claims and they denied the hospital's claims. A few days later, I received another of the same denial letters this time stating they paid $5K of the surgeon's fees and $58K of the hospital's fee and in another letter, a bill from the hospital for $27K. Um...I was told I only had to pay the deductible and the 90/10 co-insurance that would not exceed $1500. I don't want to call my insurance company because I'm scared of what they'll say. Does anyone know what this is all about? Am I going to have to call an attorney? I don't have $37K!!! If I did, I would have paid for the surgery in cash (it would have only been $12.5K) Can anyone help?!?
Thanks,
Margo:eek:
