The big showdown with Blue Cross Blue Shield
Howdy. Long time no blog. That's my fault. Firstly, I didn't want to make blog posts saying, "Still waiting to hear back from insurance. Yep. Any day now." Secondly, I've been spending my weekends either working hard and late to earn cash for my jaw surgery or recovering from a lack of sleep and exhaustion. My physician tells me I have hypothyroidism, so now I take hormone replacements for that, which has helped with the exhaustion part. She insists I get more sleep, anyway, though.
This is an update about where I stand with jaw surgery. Yes, it's taking much longer than I thought to push this through. That's because my job switched insurance providers, so I had to start the approval process all over again with our new one, Blue Cross Blue Shield, at the beginning of the year. They have been just as stubborn as United Healthcare, but much more transparent and helpful, strangely enough. I get denial of coverage letters that actually sound like the author knows what orthognathic surgery is with clearly written instructions on what my options are to continue to badger the company.
They rejected my first claim, naturally. I sent them piles and piles of records, photos, and testimonies from my doctors, orthodontist, and dentists, all the way back to when I first fell on the stairs and knocked my teeth out. So I appealed a second time.
This time they sent a letter saying my appeal would be reviewed by two surgeons on the 2nd at BCBS headquarters in Durham and that I and/or my representatives were welcome to attend in person or via phone, but that our presence was neither necessary nor required. So I have taken tomorrow off work to appear in person and have scheduled my surgeon to attend via teleconference. My orthodontist, sadly, was booked, so he could not come. But this is better than allowing them to quietly pass judgment on my condition from behind closed doors.
Wish me luck, guys! I'll be preparing my materials tonight and tomorrow morning. I look forward to a stiff drink after the day is done.
This is an update about where I stand with jaw surgery. Yes, it's taking much longer than I thought to push this through. That's because my job switched insurance providers, so I had to start the approval process all over again with our new one, Blue Cross Blue Shield, at the beginning of the year. They have been just as stubborn as United Healthcare, but much more transparent and helpful, strangely enough. I get denial of coverage letters that actually sound like the author knows what orthognathic surgery is with clearly written instructions on what my options are to continue to badger the company.
They rejected my first claim, naturally. I sent them piles and piles of records, photos, and testimonies from my doctors, orthodontist, and dentists, all the way back to when I first fell on the stairs and knocked my teeth out. So I appealed a second time.
This time they sent a letter saying my appeal would be reviewed by two surgeons on the 2nd at BCBS headquarters in Durham and that I and/or my representatives were welcome to attend in person or via phone, but that our presence was neither necessary nor required. So I have taken tomorrow off work to appear in person and have scheduled my surgeon to attend via teleconference. My orthodontist, sadly, was booked, so he could not come. But this is better than allowing them to quietly pass judgment on my condition from behind closed doors.
Wish me luck, guys! I'll be preparing my materials tonight and tomorrow morning. I look forward to a stiff drink after the day is done.