Blue Cross Blue Shield N.C. Complaint - Denied Spinal Surgery
WINGATE, NORTH CAROLINA -- My husband has a fractured spine and can't return to work until surgery is done. BCBS of North Carolina has denied his claim 2 or 3 times the doctor says surgery is the only option, you know the man with the degrees! But insurance says no he has done everything hoop for them and still not good enough. SO, what kind of !#%@ is gonna have to happen before they are shut down for good.
Here is my husband's story,
Was injured at home in May 2011. Sought four doctors. Went out of work in September 2011. Insurance denied coverage for lack of conservative treatment. Did conservative treatment but denied again. Then requested expedited review but was told to write (expedited ) on my appeal form ? And I have them recorded telling me that.
Here is their policy on that, and I quote,
" An expedited review may be initiated by calling the State Health Plan Customer Services number. The decision will be communicated by phone to you and your provider no later than 72 hours after receiving the request. A written decision will be communicated within four days after receiving the request for the expedited review."
I have isthmic spondylolisthesis and am disabled from continuous pain. May lose home because of their delays.