Insurance with Mod Quad & Caps

[Marnie]

Anyone with BCBS insurance? That is what we have and I am just wondering what kind of experience you have had with insurance and these surgeries? Are they covered? Any information will be helpful. I know that George from TCH will be calling me with information but wanted to get a head start.

Marnie
tlmsh@peoplepc.com

[NancyP]

Marnie, We had BCBS for Kelsey's first 2 surgeries. TCH now contracts with them, so you may not have a problem. We did initially. We did not have a history with TCH and it took quite a bit of work for it to get approved. Keep up with George, I call him quite a bit to see where he is. Make sure he realizes that this is your first trip to TCH (it is isn't it?) so that he can start earlier. When we went the first time, BCBS was not contracting. Good luck! Make sure your pediatrician is willing to write a letter too!

[admin]

We have BC/BS and are going to TCH for the first time at the beginning of June. TCH called our insurance company and had pre-approval for possible surgery in just a few hours. Then someone else called from Dr. Nelson's office to pre-authorize the EMG testing. No problem there either. We live in upstate New York and have BC/BS of Rochester. Hope it goes as well for you.

[Sharon & Al]

Marnie, we are taking our son to TCH for evaluation and possible surgery on June 3rd. We have BC/BS of Rochester Area (New York). We had no problems getting pre-authorized for EMG testing and surgery. This is our 1st trip to TCH, so surgery would be primary. TCH took care of pre-authorizations. We didn't have to do a thing. Hope all goes as well for you. (I tried to post this once before and it disappeared. Hope it doesn't show up twice!)

[Marnie]

Anyone else?

[Paula]

Marnie, we have BC/BS of Kansas also. We took Aaron to his first evaluation to TCH and they paid with no problem. Now he has another eval on the 3rd and primary scheduled for the 5th of June. So I called and explained to them what was going on and they said Ok that's no problem. So, I'm hoping it is no problem when it comes to them paying. I asked if I needed a referral and they said no. So far so good. We'll see though.

[Paula]

Jennifer, I just spoke to someone at BC/BS and they told me that we would be covered at the 90% rate and that max out of pocket payments on our part would be about $600.00 to $700.00 for the surgery. Maybe cause we are in different states we got different answers but you would think it is all under the same umbrella.
---Paula

[Marnie]

Paula, what state are you in and what surgeries do you have scheduled? Are you having the surgeries at TCH?

[Paula]

I'm in Kansas. Yes we are having primary done on the 5th of June and it will be at TCH.