Guest guest Posted January 22, 2004 Report Share Posted January 22, 2004 dear donna congratulations. all of my attempts with blue cross of ca. have been failures. is there any more info that you can share with us, codes contacts etc.i am planning to go to belgium within the next 2 months and money certainly is a big issue for me.i can be reached at or though the group.blessings art dann Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 23, 2004 Report Share Posted January 23, 2004 > dear donna congratulations. all of my attempts with blue cross of > ca. have been failures. is there any more info that you can share > with us, codes contacts etc.i am planning to go to belgium within > the next 2 months and money certainly is a big issue for me.i can be > reached at or though the group.blessings art dann Just incase she doesn't see your post her yahoo email address is: donnakei@... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 23, 2004 Report Share Posted January 23, 2004 Ok, here's what I did, and I hate to say it, but there was no magic formula. Before I left for Belgium in November of 2002, I called Blue Shield and told them I was going to Ghent to have my hip resurfaced. This went against a lot of advice I'd heard, i.e., don't contact them directly...let the doctor's office handle everything etc., but I chose to do it this way. I had to do a little sales job with the insurance agent who wasn't all that familiar with resurfacing. I described the procedure and as a tennis teaching pro, why I needed to have this less invasive procedure. I talked to her about the BHR and Dr. De Smet and why I felt so strongly about them. I also pointed out the difference in cost and how much money it would save them in the long run. The woman sounded very intrigued and gave me numbers to call once I got to Belgium (something I neglected to do, by the way). After I returned from Belgium, I did not contact the insurance company at all. I had to wait about 6 months for the bills from Dr. De Smet to arrive, then sent them in to Blue Shield with just a short explanatory note. (I was expecting it would be a long drawn out process, so I was saving my Big Pitch for the appeals.) They sent everything back to me with a request that I have everything translated into English...which I did for about $240 (it was a gamble, but well worth it), plus a request for doctors' diagnostic letters describing my condition and the need for hip surgery (of which I had several). I then sent the whole translated package back to them and that was it. Again, I did not send any kind of letter pleading my case. That was in November of 2003. A few weeks later, I called once to see if they had received everything and was told they were reviewing it in two parts and that it might take some time. At this point, I had an odd feeling they were going to cover it. A woman named Isara had already been successful with them, so I just felt I would be too. Believe me, though, I thought I would have to go through several denials and appeals first, so I was shocked when the check arrived without any resistance from them whatsoever. I received the check two days ago, about two months after I submitted my final bills. I still feel like I won the lottery. All I can say is, I hope my success helps pave the way for everyone else seeking resurfacing in California. Feel free to contact me if you have any other questions. Good luck, Donna in Los Angeles LBHR 11/13/02 DE SMET > dear donna congratulations. all of my attempts with blue cross of > ca. have been failures. is there any more info that you can share > with us, codes contacts etc.i am planning to go to belgium within > the next 2 months and money certainly is a big issue for me.i can be > reached at or though the group.blessings art dann Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 23, 2004 Report Share Posted January 23, 2004 How long did it take to set up the surgery once you contacted DeSmet? Did you pay him up front and how much was the total bill? Thanks so much for the info Todd Eggen Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 23, 2004 Report Share Posted January 23, 2004 How long did it take to set up the surgery once you contacted DeSmet? Did you pay him up front and how much was the total bill? Thanks so much for the info Todd Eggen Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 23, 2004 Report Share Posted January 23, 2004 Todd, I wanted some time to get ready, so I think I set it up a couple of months ahead of time. I'm sure others were able to get in much sooner. Yes, I paid $9,500 up front and as I mentioned, I got about $300 back, I think. You're welcome; I'm happy to help. Donna > How long did it take to set up the surgery once you contacted DeSmet? Did you pay him up front and how much was the total bill? Thanks so much for the info > Todd Eggen Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 23, 2004 Report Share Posted January 23, 2004 Todd, I wanted some time to get ready, so I think I set it up a couple of months ahead of time. I'm sure others were able to get in much sooner. Yes, I paid $9,500 up front and as I mentioned, I got about $300 back, I think. You're welcome; I'm happy to help. Donna > How long did it take to set up the surgery once you contacted DeSmet? Did you pay him up front and how much was the total bill? Thanks so much for the info > Todd Eggen Quote Link to comment Share on other sites More sharing options...
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