Quote:
Originally Posted by NICKG
...snip
BCBS denies the claim for:
unapproved service
out of network dr (the anestisiaologist)
out of network facility
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I just went through this with CareFirst in MD, who is a BCBS provider. Wife had knee surgery in Nov 2008, but payment wasn't made until June 2009. Lots of back and forth, never the same person to talk to, always "under review" or "open investigation" or some such nonsense.
What got my situation turned around, and I mean RIGHT NOW, was telling them my attorney was recommending a bad faith refusal to pay a claim lawsuit. Advice I got right here from the PPOT braintrust. I had a check within 10 days of telling them this.
Our situations may be different in that I wasn't denied coverage, they were simply dragging their heels bigtime.