Insurance Denied-Anthem BCBS

[gomekast 559]

Wow. I hope my insurance doesn't require a COE' date=' since the nearest one is 8 hours away! There are only 12 in the entire US![/quote']

That is an old list then or a list for just your state. California alone has more than 12 COE. My state has around 10 itself.

[Superfluous 19]

So how does one find a COE?

[macman 603]

i would think your insurance company could provide some help

[Superfluous 19]

I found it!

http://asmbs.org/member-search/

[loveelaura 52]

Can you have surgery at the place that is far away and then use your in town doc for followup?

Sent from my iPhone using VST

[crodrigu73 13]

It maybe something I will have to investigate if my appeal is denied. I just really hate the idea of being that far away from the surgeon who preformed my surgery in case there are complications. That just adds a whole new layer of concern for me, especially since I will be having two surgeries at one time. All I can do right now is pray that they will approve me and if they don't then I will work on the next plan.

[Only1likeme 69]

This will work for you. .. we are going to claim it. . when you first signed up for this WLS they should have informed you. .. my very first visit to see a surgeon to discuss this procedure I sat in the waiting room of course waiting to see the surgeon and as I walked back the receptionist stopped me and said. . your insurance requires a BDCOE and we are not? I said ok and left. . luckily there are at least 3 in my area within an hour drive but someone should have been able to give you that information before it got this far? Wishing you the best and please don't give up

patiently waiting

[crodrigu73 13]

This may have been the way it went if I had gone to a surgeon in search of VSG, however I went to a surgeon because I had an open wound that had not healed for 8 months, at this appointment I was informed that I had a hernia mesh that was infected and needed to be removed and replaced with a biologic mesh which is less likely to become infected in the future however it is not as strong so if I do not reduce the pressure in my stomach (lose a lot of weight very rapidly) I will have a hernia through the replacement in just a few months. So it was either have a weight loss surgery or have multiple hernia repairs. In addition, even if informed I still would have pursued this direction because as stated before two fellow employees have been approved by this same insurance company to have surgery at the same hospital I would like to use. It is a center of excellence for surgery just not specifically for bariatric surgery.

Has anyone else won an appeal with their insurance company?