Regence BCBS Denying Paying for Assistant Surgeon for DIEP

TWG

Hi,

I have Regence BCBC in Washington and they are denying paying for an assistant surgeon for my DIEP surgery. Have any of you dealt with this problem and did you get it reversed? Any help would be appreciated. Thanks!

Falconer

TWG, I had to deal with insurance issues after my DIEP as well. As if this all isn’t stressful enough!

My situation was resolved bc I received the number of our local health insurance collective negotiator. I contacted him with the situation and he was able to resolve the issue within 24 hours- and this is after months of my appeal and hours of calls with BCBS. Do you have a group plan? Maybe you can get a phone number for someone who negotiates your groups policy. Good luck. It’s so exhausting. But it will get resolved.

BlueGirlRedState

I did not do reconstruction, but I have had with BCBS federal, and get confused when some statements are just BCBS and others BCBS Regence, then all the stuff about deductables/co-pays/not covered etc. I have not worked with a negotiator as one person mentioned, but that sounds like a good start. Is there a nurse navigator who might be able to help with who to contact? Even with the stress of what you are going through now, you may need to call the facility and find out more about an assistant surgeon (is that usual with DIEP? were you informed ?) There was an interesting story on NPR today (unfortunatey I only caught a snippet) on health insurance, in network/out of network, people not told that a particular DR/specialist etc was out of network even though the facility was in network. In the story, some people were able to negotiate for a reduced or even no-pay. Good luck to you