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BCBS-IL PPO three things

Discussion in 'Insurance Issues' started by TheFormerLantusFiend, Feb 3, 2009.

  1. TheFormerLantusFiend

    TheFormerLantusFiend Approved members

    Joined:
    Sep 10, 2006
    Messages:
    4,925
    1.I talked to the MM rep for the area a few hours ago and he says that the PPO is coming out in the next week or two with a list of what they'll cover without you haggling, and that they're in contract negotiations with MM and he expects that my sensors will be covered as of about two weeks from now. This is great news, although it's tentative. He says not to order anything right now because of the probability that I will be covered in a couple weeks.
    :D

    2. BCBS sent us another letter claiming that I wasn't a student and therefore wasn't covered. It is making me mad! This is the second time, and I AM a full time student.
    :mad:

    3. BCBS used to have people answering the phone if you called customer service. But I've called at a variety of times during business hours on more than ten occasions and not gotten through to customer service. I've been rerouted to "please hang up and call this 800 number again", to precert, to nursing, to the pharmacy, to the provider line. But not to a customer service person.
    :(
     
  2. friochic

    friochic New Member

    Joined:
    Mar 20, 2009
    Messages:
    2
    Blue Cross Blue Shield of IL CGMS approval today!

    :D

    My 2nd appeal for a Dexcom CGMS was APPROVED today thru Blue Cross Blue Shield of IL.

    A little known fact - the sensor CPT (billing code) A9276 was approved for payment for all of BCBSIL members on 3/1/09. I put in my first appeal on 3/4/09 and was flatly denied on 3/6/09. My next appeal letter was received on 3/9 and I was approved this morning. I used the argument that one of the three billing codes was approved - why not all?

    I am hoping this helps other BCBSIL members.
     
  3. TheFormerLantusFiend

    TheFormerLantusFiend Approved members

    Joined:
    Sep 10, 2006
    Messages:
    4,925
    PPO or HMO?

    The MM rep says that BCBS has promised to come out with a revised policy on CGMS coverage on April 1 and will put it on their website at that time.
     
  4. friochic

    friochic New Member

    Joined:
    Mar 20, 2009
    Messages:
    2
    Cgms approval

    Important question - I have a PPO
     

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