Question about pre-surgery office visits and insurance

[cmathews77 10]

First of all, I have BCBS of AL and it does cover WLS. So, I am on month 2 of my 6 month supervised diet. I went to see my surgeon a few weeks ago and they gave me a list of other appts. that I've got to have with other doctors (ex. psych visit, nut. visit, sleep apnea test, ect.). My question is how are those appts. covered under my insurance since I haven't been approved for the surgery. The surgeon's consultation was filed on my insurance, but I got a bill today for over 300.00 with my insurance not paying any of it. I can't afford to pay it and out of pocket for all of the other tests and appts. that I've got to have. Anyone else have an issue with this? Can anyone offer any advise as to how your insurance worked or what you had to pay?

Thanks a bunch!

Connie

[Kygirlkeshia 11]

I also have bcbs of al, I haven't had my first visit yet but the way they explained it to me was it covered 100% with no deductible if I had it done at a center for excellence with a center for excellence surgeon. Or it will cover 80% in network.

[want2clessofme 26]

I am so glad you asked this question! I just received a statement from my BCBS (Federal - basic) stating that "we do not cover treatment related to obesity, weight reduction or dietary control." They have denied paying for my chest xray and say I owe the $241 to the provider.

I have a psych. eval next week, a cardio clearance appt. the week after and am wondering if I am going to be billed for all of those - not to mention the EKG, physical, consults I have already done. They also want a more recent sleep study done.

My insurance DOES cover wls - so I am confused as to why they are not approving payment for all the test requirements.

[biglerm357 3]

I am on BCBS Federal and I was recently approved. I didn't have to do a sleep study or cardio. But I had to do a drug and nicotine test to get final approval. Has this happened to anyone else?

[cmathews77 10]

I finally spoke with my insurance. The lady I spoke with wasn't sure why it was denied since my policy does cover wls, so she resubmitted it and kept track of it to see if it was denied again and why. She called me back a few days ago and said that it was denied again b/c I haven't been approved for the wls yet. She said I could either work it out with my surgeon's office to wait until approval to pay for the visit or go ahead and pay the surgeons office and get reimbursed. I hope this is not the case for all of my other visits and tests.

[want2clessofme 26]

I called BCBS Fed yesterday and they said to call the provider (of my chest xray) and have them re- bill it as preop test for diabetes control ... not for weight loss and it should be covered. I will let you know how that comes out