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I have BCBS and they said they cover the procedure 100% except for a $75.00 co pay. Can anyone tell me how this works with Chapel Hill since they don't accept insurance payments. Do I have to pay up front and then the insurance reimburses me????
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Usually insurance will not pay for tubal reversal due to it being an elective procedure. Anyone can try and file a claim with there insurance company. First call your insurance company, then they will get you the proper paperwork for your Dr. to fill out and then you will get a letter from your insurance company which will let you know if it is a covered procedure. We also offer a few payment options which are expalined at the link below.
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Everyone's BCBS is different. My dh had bcbs at one employer and under this policy my TR would have been completely covered. That employer changed to a different insurance and dh took a better paying job somewhere else. We have BCBS again now, but this policy doesn't cover any of the procedure. You have to study the fine print. GL!
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Thanks Ericka, it's just difficult to here the insurance company say "if" they knew the cost of everything they would reimburse part of the fee. They would actually pay for consult, ultrasound, anesthesia, meds, and post op care. Just not surgery. That being said, we all knew that getting the insurance to even consider paying would be like pulling teeth. It simply is NOT covered with the majority of insurance companies. And they look for the procedure to be of "medical necessity" too. No fault of CHTRC. I am grateful for CHTRC and my being WHOLE..no matter what the insurance co. does! You guys are AWESOME!
Chapel Hill Tubal reversal center can not provide itemized bills because the fee that you pay is all-inclusive. Lab work and ultrasounds performed in the office are also included in the fee. If we were to begin breaking down these charges, the overall cost for tubal reversal would increase.
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I am a little concerned myself but I have heard from the boards that some have had BCBS and gotten partial or full payments so I am praying and keeping a good outlook. It makes me wonder though why CHTRC doesn't give an itemized list? I think it makes the form easier for them and for us to understand. I wish I ould get one that had the ultrasound and my bloodwork since I got it there. I think it sucks since when I got my tubal I was unaware of PTLS and I would have NEVER gotten a TL in the first place if I had known. But when I concieve it will be well worth my money even if I don't get any back from BCBS! But I sure do wish that CHTRC would reconsider there invoice for future patients. I hope that some of us get a little back *smiles* lets all cross our fingers and pray hard!! Heather
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My husband has BCBS of Texas through his job and they stated that they would not cover it. Is there anyone that had BCBS say that it was not covered but filed a claim after the surgery and was reimbursed all or part of the monies?
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dreamweaver, my husband is with the fed govt too. we have bcbs fep delaware. but because surgery was in north carolia, my claim went to them. Hmm. Now that I see what they told you I am concerned. I submitted a request for reconsideration.
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faeriehawk, my insurance needed an itemized bill too. But CHTRC said it is "all inclusive". They do not give it to you broken down. You can only use your receipt from the surgery. The insurance co is trying to see if the surgery was "of medical necessity". arghh
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My DH is a firefighter for the federal government and we have BCBS fep (NC). Because Dr. B list just the one code, which is all-inclusive and does not break it down, BCBS did not pay for my TR. Reasoning is because the TL was elective. They did tell me that if the TR was broken down some things would be covered. Also, as someone did mention, it depends on what your employer has in their plan as everyone is different. Good luck Karen
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oh I found my reciept I think this is what they are talking about!!!! I am so glad. I get confused on how to do any of this. Could someone point me in the right direction to fill this out It asks about a illness injury thing. I guess I out blocked tubes right? I hate claim forms. I can never understand them and I'm afraid of making a mistake. Heather
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My BCBS of GA. needs some itemized list. with codes and CHTRC tax id number and so on I am so confused!! I'm almost in tears I am so frustrated someone please help me! Heather
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the website fit to be untied has a number of different codes posted and an entire thread for bcbs as well as what states have what kinds of laws regarding coverage. and members can get a discount for Dr. Berger or so it says........ you can probably find everything you need to know and then some there.
UBBFriend: Email this page to someone!
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That being said, we all knew that getting the insurance to even consider paying would be like pulling teeth. It simply is NOT covered with the majority of insurance companies. And they look for the procedure to be of "medical necessity" too. No fault of CHTRC. I am grateful for CHTRC and my being WHOLE..no matter what the insurance co. does! You guys are AWESOME!
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