Hi friends. A year post my first surgery and Blue Shield of CA has finally paid my surgical claims from both surgeries! After a long battle they finally retroactively authorized the surgeries but then the fun and games really began. First they reprocessed the original claims and then once again denied them. Then they had me have Banner Health submit new claims and they denied those as well…even with the authorization in place. It was a game of procedure codes that I could never win because Blue Shield of CA wouldn’t speak directly to Banner it had to be the local Blue Shield office and they were apparently out of the loop. Anyway, with the help of the CA state board of insurance Blue Shield of CA finally gave up the game and I see on my insurance dashboard that all the claims have been paid. Now I just have to deal with Banner and the anesthesiology group to get reimbursed. Just wanted to share the good news, especially for anyone struggling with getting insurance approval.
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That’s great news! I hope it doesn’t take too long for you to be reimbursed too, all sounds very stressful so glad that it’s nearly over! 
@Chrickychricky - I feel that BC of CA’s behavior is inexcusable. You pay for your medical insurance in good faith. You followed their out of network guidelines also in good faith so there is no reason you should have had to jump through the hoops they set up over & over again for a year. I think they owe you more than a reimbursement … like a major apology! I applaud you for maintaining the upper hand & finally receiving the “prize” at the end. What a ridiculous ordeal!!
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