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Re: insurance approval for out-of-network From: Michele (anonymous@obgyn.net) Mon Sep 22 09:59:46 2008 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Karen: "lap vs hysterectomy" Previous message: MLS99: "Re: How long is the abdominal discomfort supposed to last after lap?" In reply to: anonymous: "insurance approval for out-of-network" Hello, I had bc/bs HMO and they denied my surgery. Thanks to my Dr. , the hospital and my letter yes I did get almost full coverage. They only took out a $100 deductable. My surgery was $15.500 they paid me 15,400. It took a few months but it was worth the fight. You have to prove to them that there is no Dr. in your plan that can do this type of surgery. I had excision surgery. The letter your Dr. will write for you will help prove it. I know about the hip. I do not know how there appeal process works. I live in NJ but an hmo is an hmo. I wish you luck. Do not give up!! At Sat, 6 Sep 2008, anonymous wrote: > >i reside in nyc and have hip hmo. i need a lap by an out-of-network >surgeon. has anyone had success getting full coverage? the receptionist >at my dr. office has seen someone who got full coverage for an >out-of-network surgery with hip. > >my dr.s office provided a letter of necessity but advised that i submit >a letter to them as well. > >any advice, or sample letters would be greatly appreciated. Next message: Karen: "lap vs hysterectomy" Previous message: MLS99: "Re: How long is the abdominal discomfort supposed to last after lap?" In reply to: anonymous: "insurance approval for out-of-network"

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