One day you all will read about a woman from Mid South Tennessee who hunted down and
tortured a BCBS claims mediator...
Got a letter from BCBS medical claims mediators that told me it was
necessary that I go through with the scans as scheduled... the risk
of inter cranial infection was not worth risking not keeping the
Now don't let what we are going to tell you not keep your
appointment... we (BCBS) are not going to pay on these scans
because we have dropped that service provider...
then they go on to tell me again that I must for my health and well
being have the scans ...called center and all the MRIs and the CT
scan are going to be around $8000 ... BCBS said they will work to get the
reduced price of $6000 that was contracted with the center before they
dropped them ...
ain't they so nice ...
Doctor sent me to the center instead of the hospital radiology
department because they do good scans and charge less than
the hospital... now got to try to fight them as it was set up before
they dropped the place or get an appointment at St Thomas ...
And it seems they should still pay the out of network amount
which is 70% after deductible is met instead of in-network 85%..
Our local go between with insurance is out of town until Monday... CT scan
appointment is Monday at 9:00 with MRIs to follow and I am suppose to be there
Gonna be on phone tomorrow trying to get them to honor it since the arrangements
was made prior to them dropping facility... that is the angle the doctor office said to take ...
or reschedule with someone they will cover ...and going to call BCBS and question why they
won't even pay at the out of network rate if I go to the facility...
I got the mail at about 1:00 and had to pick up my Girl Scouts at 2:30 so didn't get alot
done as far as working something out ... got to school and was waiting for them and the nurse
said I looked funny ...my lips were tingling and a little light headed ... she took my BP and
it was 187/100 ... instead of going down the road to community building we just stayed
at school and made Christmas cards that have to be turned in my the 5th to be shipped
to Iraq... by 4:00 my blood pressure was almost normal and I felt better
Even though they backed off on classifying me as Pre-existing when the insurance changed in
their seamless transition
, that is what they are doing anyway and calling it everything but
not covered due to pre-existing complaint ...they are throwing road blocks in front of me
every step of the way...
I wanted to sit down and cry...roll on the ground screaming and other things I don't normally do...
I was so happy after visit with new doctor because it looked like things were going to start happening ...
now I am kinda just numb all over...
I talked to husband and we have decided that I am going to go through with the scans Monday
and worry about it later if I can't get a new appointment within a week ...not going to fight
them a month to get it done when it should have been done a long time ago...
I am so tired emotionally ... almost wish I had just kept Bennie and not have had all the after
crap to deal with ... that doesn't last long with two doctors telling me that he
would have soon put breathing at jeopardy... I like breathing ... but life was so much easier with
him in my head