Anthem Blue Cross PPO in California?

[stranger9876 0]

Greetings all,

Any luck or insight into the Anthem Blue Cross PPO coverage for lap band? I researched seminars at UCSD, but their info clearly states that they are not a ABC PPO approved facility.

Help is appreciated! I would love to join the throngs of happy and successful lap-banders! :thumbup:

-paige

[Jennifer77 0]

Start with the surgery centers themselves. Call around to all the bariatric surgery centers and ask if they are a "Blue Cross Center of Excellence (COE)". Blue cross only covers the procedures at the centers THEY deem as COE. After talking to tons of Dr.s offices by looking them up on my Anthem Blue Cross website, and hearing that the Dr. is a contracted physician, I would start the process only to find out that the center that the doctor uses is not a COE therefor ABC would not cover it. I called around to about 8 different surgery hospitals/centers before I found a location that was COE. And then from there I asked them which physicians on staff were contracted through ABC as well. And that's how after six months of searching, I finally found the center and doctor that my insurance would cover. Good luck. In this day and age you need to be your own advocate. Alot of Dr.s are dropping their contracts with the insurance companies because they are quite frankly getting screwed by them. I work at a brand new surgery center, and we don't contract with anyone because we would loose too much money and be unable to stay open. Make the calls and make sure you are asking the correct questions, and you should do fine. BTW, blue cross is terrible about paying for the after care. As far as your fills and such, you may need to pay for those on your own. I ended up paying a "fee" after my insurance pay outs to cover the cost of my aftercare (fills, consults, post procedure follow up visits). Again good luck.

[Jillbeme65 1]

Greetings all,

Any luck or insight into the Anthem Blue Cross PPO coverage for lap band? I researched seminars at UCSD, but their info clearly states that they are not a ABC PPO approved facility.

Help is appreciated! I would love to join the throngs of happy and successful lap-banders! :thumbup:

-paige

I am using Top surgeons through West Hills, My doctor is covered in plan but the surgery center is not causing my out of pocket to go up. I called the insurance the lady suggested that I call the surgery center and ask them to accept the 80% as pif. I thought she was nuts... I called the lady handling me through Top Surgeons she gave me the number to call and Wham I talked to the director and sure enough they will take it IN FULL... Woo hoo

[robtyty 0]

I am using Top surgeons through West Hills, My doctor is covered in plan but the surgery center is not causing my out of pocket to go up. I called the insurance the lady suggested that I call the surgery center and ask them to accept the 80% as pif. I thought she was nuts... I called the lady handling me through Top Surgeons she gave me the number to call and Wham I talked to the director and sure enough they will take it IN FULL... Woo hoo

Hi, I also went to a Doctor in West Hills. They called Blue Cross and was told that I did not have ANY benefits!! I called Blue Cross and they apologised, but I sense a scam!

What was the number at Blue Cross?