Highmark BCBS

baileyj908 · November 8, 2015

Anyone have highmark blue cross blue shield? Wondering how long it took for approval of surgery?

animallover1247 · November 10, 2015

I haven't had surgery yet but so far I AM NOT IMPRESSED! I had my endoscopy last week (which is required by my surgeon). I am able to check my claims online and they paid for the surgeon to perform the endoscopy and they also approved payment for the doctor who did looked at my polyps from the surgery. However, they denied payment for the endoscopy itself. What kind of sense does that make? So, they say I now owe $6231.92!! I called the hospital this morning and she said BCBS looks for any reason they can to deny payment. They told me they would get my records and appeal the decision. Sometimes they pay on appeal, sometimes they don't. So...I am wondering what kind of tricks they will pull out of their ass when it comes time to approve my surgery!

I have a friend who had BCBS and she had no issues with the endoscopy or surgery and she didn't even have any co-moribid conditions.

I hope you don't have any problems!

Edited November 10, 2015 by animallover1247

meltravlr · November 10, 2015

I was just denied for my surgery based on my 2 year weight history because one BMI was 34.5...????. Needless to say I am going to appeal but just so disappointed. Hope yours goes smoother.

lorri716 · November 10, 2015

I have highmark bcbs and o know they require a bmi of 40 or better. Also I didn't have any issues with payment. But I also have a 3000 deductible that I had to meet first.