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» Tubal Reversal Message Board » Tubal Reversal Cost and Financing » Insurance coverage Blue Cross Blue Shield (Page 2)
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Digger
Member # 7585
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I called BC/BS and they said that my TR would not be covered.I have read on here about women that were told that and they filed anyway and then got at least a portion of their fee back.Needless to say,I filed my claim today and hopefully will get something.If I do then great and if I don't at least I tried.Best of luck to all you ladies [Kiss]
Angela
Tlm
Member # 3558
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The Physician ID # is the thing I had a hard time explaining to Blue Cross. They had never heard of this, therefore asked if I was sure I wanted to use "This Doctor". I told them most of our Dentist offices around here don't deal with Insurances either. They will give you a paper to send in for a claim, but they don't take Insurances. For you that have BC/BS of Alabama....they will NOT pay you for the Ultrasound or anastestia(person that puts you to sleep). They will deduct this from your claim...they won't tell you that until the claim is filed.

Tammy
Ericka P
Member # 1953
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Hi Digger, because we are a fee for service facility and the patients are self referred, there will not be a referring physician ID #.

Ericka
[CHTRC]
motherof2
Member # 8207
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I called my insurance co to verify the coverage. BS/BC and I gave her the CPT code and mine is covered at 70%. That is still great news [Smile] They should pay about $3800.00 of the $5500.00.Out of pocket $1700.00.
Digger
Member # 7585
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My BC/BS claim form asks gor a ID # of referring physician.Does anyone know this?Thanks
ncfamily
Member # 6933
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Lori

Thanks! I like the way you said God may grace your claim though. I think we sometimes forget who is in control. I needed that today!
God Bless
Ill Pray all our claims are graced through as Lori said.
Best of Luck

Julia
virtuous3110
Member # 8515
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Hi everyone....
I live in Burlington, about 25 minutes from CH..I also work at BCBSNC...we currently DO NOT cover TR on the individual policy (Blue Advantage. Each BCBS in the perspective states run independant of one another so the benefits read differently. The group policies, however, are different and is dependant upon how the particular employer set up the benefits. I have to pay for mine but I dont mind b/c before I started working there I knew they werent going to cover it. I like the idea of submitting the claim anyway b/c they are processed by humans and there are a lot of mistakes made EVERYDAY...God may just grace your claim through and allow it to be paid. I think I may even submit mine!

Lori
K.O.
Member # 5046
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We have BCBS of AL also through my dh work. It covered our TR ~~ all we had to pay was the $100.00 out-patient surgery co-payment.
BUT not all insurances [POLICIES] will cover this procedure. We were very fortunate and very blessed to have this coverage.
Kim
Julia S, RN
Member # 10
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Dear Amyjbusskohl:

What you may have been told is a little misleading. Having done this for many years, I have never heard of a situation where reimbursement for TR surgery was dependent on a letter from the doctor. Unlike other medically necessary procedures, it is just a matter of whether your specific policy allows coverage for CPT code 58750 ( tubotubal anastomosis). Since no insurance company recognizes reversal surgery as a procedure that is medically necessary, a letter from a doctor would not matter. Your policy contract either provides coverage -- or it does not. I would definitely ask for them to put their response in writing, however.

Julia Smith, RN
[CHTRC]
Tlm
Member # 3558
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I just made sure it was covered. Blue Cross told me to pay for it and get the "code" for it and submit it to them. I had no problem getting my money. The check came just a few days after submitting it. I was sooooooooooo happy. I always had heard of Insurance companies not doing what they said they would do. I know couples right now that have dropped their work Insurance and have switched to Blue Cross just for the benefit of having the Reversal.

What part of Alabama are you in?
Tammy~~~Dothan
motherof2
Member # 8207
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Did you have to get any paper work filled out to sent to the insurance before the TR.
Tlm
Member # 3558
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Oh yeah, I also have an awesome Fertility treatment plan. It covers IVF and all the other stuff.

Tammy
Tlm
Member # 3558
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I have Alabama Blue Cross and it paid for my Reversal. I had to meet the deductable first. Plus, Dr.Berger was out of my network. I paid up front for the surgery, $5500.00 and I got back almost $4000.00. So that wasn't bad at all for us.

Tammy
We took a plan out. We are Self Employed.
motherof2
Member # 8207
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I have BS/BC of Alambma and they advised me that my policy covers the TR at the following rate:
70% out of network
90% in-network
JAY JAY
Member # 8497
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STEPHG124NY #7023
THANKS FOR THE INFO
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