posted
I have blue cross of ca. My LLMD gave me a new prescription for bicillin LA and biaxin. I took it to Costco pharmacy and my insurance immediately denied it. So far my insurance has paid for 5 months of mepron and zith. This is a new set of meds. I do not have a maximum that the insurance will pay on meds. Any suggestions? Are other people's insurance paying for bicillin and biaxin? Or is that a usual med to get denied. Thanks!
Posts: 293 | From healdsburg, ca , sonoma | Registered: Feb 2005
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I have Blue Cross and Blue Shield in another state and when I get denied for anything I can just call them. They'll tell me why it was denied and what I would need to do to get it approved. Very often I can clear up any problems over the phone. Sometimes it's just a matter of an incorrect Dx code being entered.
Posts: 67 | From Kansas City, MO | Registered: Sep 2004
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HEATHERKISS
Frequent Contributor (1K+ posts)
Member # 6789
posted
BCBS is notorious for unwarrented denials. Usually a call does the trick.
Don't give out more info than you have to.
They have denied for an in metwork hospital test and in network Doctor. I called and told them of their blunder and they fixed it.
I think alot of people don't call and straighten them out.
Be polite. Firmly state that you need to have uninterupted treatment or you'll lose ground and possible become sicker.
Oh yea, never lose your medicine. Under my plan they don't replace lost or comprimised medicine.
Good Luck,
-------------------- HEATHER
Posts: 1974 | From ABERDEEN, NJ 07747 | Registered: Jan 2005
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riversinger
Frequent Contributor (1K+ posts)
Member # 4851
posted
I have BS of CA. They deny everything they can, even when the policy specifically includes it. Start with a phone call. If that doesn't work, you can make a complaint. I have gotten almost every appealed charge covered, but I know it depends on your policy. Make sure you quote from your policy when making the complaints.
posted
I also have BCBS in another state. When I first started zithromax they denied it. All I had to do was have the dr call and tell them it was medically necessary. Had to do the same for hubby and daughter. Hope you can get this worked out. Don't give up without a fight.
Take care, Sapphire
Posts: 495 | From KY USA | Registered: Dec 2004
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