Issues with BCBS

[mrstrekkie84]

Anyone else having problems with Blue Cross Blue Shield? I recently learned that they haven't been paying claims to our dialysis center over the past several months even though they had renewed the contract until August 2015. Supposedly, many patients have been having this problem. A case manager from BCBS called and told us to switch to another dialysis center, one that would be in-network. However, none of the centers suggested offer staff-assisted home hemo. We have Medicare now so I don't understand why BCBS can't cover what Medicare won't. BCBS has been paying for staff-assisted dialysis for almost 2 years so why the sudden change? I'm not getting answers from them so I was wondering if anyone else has ran into this problem? It would be extremely difficult for us to switch to in-center dialysis at this time.


Also, I want to thank everyone for being supportive and helpful. You guys are awesome!

[Deanne]

I had them tell my the lab my dialysis center used was out of network in late 2013 / early 2014 and had to file an appeal. It was approved after that. This week, I had to file another appeal because the surgeon who removed my parathyroids requested a nuclear scan before surgery and BCBS deemed it unnecessary. It'll be a month before I hear anything back from them. I'm post-transplant now and don't know if that makes a difference. BCBS is my primary until this fall / winter.

[mrstrekkie84]

I'm currently in the middle of writing an appeal. Wish me luck!