Need your help setting precedent for appeal!

Shay · #1 (**permalink**) 08-27-2011, 08:01 PM

"My name is Shay Weer, and I have BCBS of WA Insurance. BCBS has denied my request for L-ADR, one level surgery. Has your insurance company paid for it? If so, I need your:

1. First and last names
2. Name of insurance company
3. Date of treatment
4. Doctor's name

I will also with your permission post this here upon completion for others to benefit from!

I've found bits and pieces of this information, but it would help all of us if we had a central place for such important info!
Thanks for your help!
We will win!
Shay Weer

dshobbies · #2 (**permalink**) 08-28-2011, 06:32 PM

Hi Shay and welcome to the forum,

I think you'll find, though some ins. co are beginning to pay for ADR surgery, most still do not and BC is one of the nay sayers.

By all means, try to get this covered but don't put too many eggs in this basket.

What are your circumstances? Why do you need surgery?

Dale

mmglobal · #3 (**permalink**) 08-29-2011, 08:11 PM

Shay,

BCBS of California is the worst of the worst. Getting them to pay is highly unlikely.

I do have a successful appeal letter (for BCBS) that I can send you with personal info redacted. I may be able to put you in touch with the author.

I know a local doctor who is quite aggressive with the insurance companies and may be able to help you. Please contact me off the forum… call the number on the GPN website linked below.

Mark