Blue Cross Denying New Treatment

Dunno about that company but they can be a pain. It is really up to your doc to get it approved. Calling the insurance yourself at least from my experience was very frustrating and stressful. Sorry you have to deal with the insurance company and a doc office that seems to have dropped the ball a bit. You are going through enough without this hassle. I found when the insurance gives such timelines it is really a bunch of malarky. 24 hours becomes 72 then becomes 5 to 10 business days and so on. I won by going back home and my local doc got my treatment approved.

Artie

Dunno about that company but they can be a pain. It is really up to your doc to get it approved. Calling the insurance yourself at least from my experience was very frustrating and stressful. Sorry you have to deal with the insurance company and a doc office that seems to have dropped the ball a bit. You are going through enough without this hassle. I found when the insurance gives such timelines it is really a bunch of malarky. 24 hours becomes 72 then becomes 5 to 10 business days and so on. I won by going back home and my local doc got my treatment approved.

Artie

Dunno about that company but they can be a pain. It is really up to your doc to get it approved. Calling the insurance yourself at least from my experience was very frustrating and stressful. Sorry you have to deal with the insurance company and a doc office that seems to have dropped the ball a bit. You are going through enough without this hassle. I found when the insurance gives such timelines it is really a bunch of malarky. 24 hours becomes 72 then becomes 5 to 10 business days and so on. I won by going back home and my local doc got my treatment approved.

Artie

Christine-

First, sorry you had to go through that. I had similar experiences with scheduling surgery and getting it approved. Just a bunch of crap….and my insurance company was telling me wrong info. Just makes my blood boil thinking of you sitting there. Artie is right, stay on your doctor….they need to provide validity of getting you treatment. Me personally, I always called too; just to keep fire burning. Sorry…hope they get it sorted out quick!

Josh

Christine-

First, sorry you had to go through that. I had similar experiences with scheduling surgery and getting it approved. Just a bunch of crap….and my insurance company was telling me wrong info. Just makes my blood boil thinking of you sitting there. Artie is right, stay on your doctor….they need to provide validity of getting you treatment. Me personally, I always called too; just to keep fire burning. Sorry…hope they get it sorted out quick!

Josh

Christine-

First, sorry you had to go through that. I had similar experiences with scheduling surgery and getting it approved. Just a bunch of crap….and my insurance company was telling me wrong info. Just makes my blood boil thinking of you sitting there. Artie is right, stay on your doctor….they need to provide validity of getting you treatment. Me personally, I always called too; just to keep fire burning. Sorry…hope they get it sorted out quick!

Josh

The places I'm seen at have always 100% handled the insurance approvals for me. They seem to be fully on top of it. As far as I've known I've never been denied by BC/BS. If there was a denial, it was handled behind the scenes without me ever being the wiser. So far I've had zero interaction with BC/BS (PPO) over the last 4 years. Knock on wood. 

The places I'm seen at have always 100% handled the insurance approvals for me. They seem to be fully on top of it. As far as I've known I've never been denied by BC/BS. If there was a denial, it was handled behind the scenes without me ever being the wiser. So far I've had zero interaction with BC/BS (PPO) over the last 4 years. Knock on wood. 

The places I'm seen at have always 100% handled the insurance approvals for me. They seem to be fully on top of it. As far as I've known I've never been denied by BC/BS. If there was a denial, it was handled behind the scenes without me ever being the wiser. So far I've had zero interaction with BC/BS (PPO) over the last 4 years. Knock on wood. 

Hi Christine,

I actually came on the board today to ask my own question about Blue Cross Blue Shield and one of my charges. However, I saw your post and felt I'd have some advice. 

I first did chemo, as prescribed by Mayo Clinic. I then found a melanoma specialist at  M.D. Anderson. She put me on Ipi/Nivo combo (a trial when I started in March).  Since I had been on chemo and soon after switched to the trial, my doctor had to call and have it approved. We did this before I started.  Although it was a trial, Blue Cross Blue Shield still fully covered it. I'm confused as to why they will not do so for you. I agree with everyone else, get your doctor to call in. 

However, we have found that it works best if we also call. We've gotten to the point where we ask for the same representative. It is so much easier than explaining your case over and over again. If you talk to someone and you feel they are competent, ask for their name and each time you call ask for them. BCBS will only give case managers to children with cancer, but they do allow you to ask for specific representative.  You can also give your doctor that specific person's name. 

Also, I understand why you were frustrated with your doctor's office. They shouldn't of had you come in that day. The one thing I will say is at least they warned you. It is much easier to take care of this before you've had the treatment. 

Best of luck,

Ashley

Hi Christine,

I actually came on the board today to ask my own question about Blue Cross Blue Shield and one of my charges. However, I saw your post and felt I'd have some advice. 

I first did chemo, as prescribed by Mayo Clinic. I then found a melanoma specialist at  M.D. Anderson. She put me on Ipi/Nivo combo (a trial when I started in March).  Since I had been on chemo and soon after switched to the trial, my doctor had to call and have it approved. We did this before I started.  Although it was a trial, Blue Cross Blue Shield still fully covered it. I'm confused as to why they will not do so for you. I agree with everyone else, get your doctor to call in. 

However, we have found that it works best if we also call. We've gotten to the point where we ask for the same representative. It is so much easier than explaining your case over and over again. If you talk to someone and you feel they are competent, ask for their name and each time you call ask for them. BCBS will only give case managers to children with cancer, but they do allow you to ask for specific representative.  You can also give your doctor that specific person's name. 

Also, I understand why you were frustrated with your doctor's office. They shouldn't of had you come in that day. The one thing I will say is at least they warned you. It is much easier to take care of this before you've had the treatment. 

Best of luck,

Ashley

Hi Christine,

I actually came on the board today to ask my own question about Blue Cross Blue Shield and one of my charges. However, I saw your post and felt I'd have some advice. 

I first did chemo, as prescribed by Mayo Clinic. I then found a melanoma specialist at  M.D. Anderson. She put me on Ipi/Nivo combo (a trial when I started in March).  Since I had been on chemo and soon after switched to the trial, my doctor had to call and have it approved. We did this before I started.  Although it was a trial, Blue Cross Blue Shield still fully covered it. I'm confused as to why they will not do so for you. I agree with everyone else, get your doctor to call in. 

However, we have found that it works best if we also call. We've gotten to the point where we ask for the same representative. It is so much easier than explaining your case over and over again. If you talk to someone and you feel they are competent, ask for their name and each time you call ask for them. BCBS will only give case managers to children with cancer, but they do allow you to ask for specific representative.  You can also give your doctor that specific person's name. 

Also, I understand why you were frustrated with your doctor's office. They shouldn't of had you come in that day. The one thing I will say is at least they warned you. It is much easier to take care of this before you've had the treatment. 

Best of luck,

Ashley

I have no advice on BC/BS but I am interested in knowing the process your Dr's office goes through.  I am waiting for notification of denial/appeal/acceptance for Ipi/Nivo combo as well for stage IV with BC/BS as my primary- day 7 of my wait.

I have no advice on BC/BS but I am interested in knowing the process your Dr's office goes through.  I am waiting for notification of denial/appeal/acceptance for Ipi/Nivo combo as well for stage IV with BC/BS as my primary- day 7 of my wait.

I have no advice on BC/BS but I am interested in knowing the process your Dr's office goes through.  I am waiting for notification of denial/appeal/acceptance for Ipi/Nivo combo as well for stage IV with BC/BS as my primary- day 7 of my wait.