An insurance puzzle ..help if you can.

[loveangelpet 0]

I was pre approved for my surgery that i had in november. All the i's dotted and t's crossed, so i thought. Well it seems now we are here in April and the surgeon has been paid along with his assistant and anesthesiologist(sp). However, my insurance, Benefit Management (branch of bcbs) is denying the payment to the surgical facility i had the surgery at, saying my weight problem is pre-existing>? NO DUH!! What exactly they want I dont know as of yet other then to speak to my other few dr's i've seen through the last year. My cardiologist who told me i needed to lose weight althougth treated me for blood pressure not weight loss, my surgeon who sent everything they say they didnt receive, and my general practitioner who i did see 6 months prior to surgery for weight loss as per requirements for the surgery to be covered!! UGH! I dont know what i'll do because I dont have $20,000 laying around that the center is charging. Stress Stress, any advice , or just something to read to make me feel better. Thanks in advance.

[celticdreamer 0]

Appeal, appeal, appeal! Also, provide them with MORE copies of what you already sent them. Call to confirm they received the documents if you fax them.

If all else fails, contact your state's insurance commissioner. How they could pay the surgeon but not the facility is beyond me.

Reminds me of when my brother's triplets were born. The insurance company paid the medical bills for the two girls but refused to pay for the boy. As ridiculous as that was, it just took a lot of fighting to get the insurance company to do the OBVIOUSLY right thing.