Posted on:
Oct 1, 2010 06:50PM
A
Joined:
Oct 2010
Posts:
1
Latest activity:
Oct 1, 2010
Posted on:
Oct 1, 2010 06:50PM
angboy
wrote:
I recently bought a compression bra for lymphedema and the cost was $120. The place I bought it told me they thought my insurance- federal BC/BS reimbursed $50 so I'd pay the difference. I paid $70 and they filed the claim. Meanwhil I called BC/BS and was told by someone that since I got it from a preferred provider, they'd pay 100% of the billed amount, so I thought I'd get the full $120 paid. I called BC/BS today to ask about it and was told they paid $39.50, the allowed amount. I couldn't find ANYWHERE any documentation of what the "allowed amount" is. Does anyone know how I can acess this info somewhere?
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lauri
Joined:
Apr 2006
Posts:
259
Latest activity:
Jan 4, 2022
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Oct 4, 2010 07:27AM
lauri
wrote:
Eventually you'll get an EOB (Explanation of Benefits) that will spell it all out -- sounds like there's a maximum amount BC/BS shows as "reasonable and customary" and then they pay a percentage of that. When I was going through treatment I went on the BC online system and left them email notes asking questions (beats sitting on the phone!) and they generally respond quickly.
From the ashes of disaster grow the roses of success
Dx
3/8/2006, ILC, Left, 6cm+, Stage IIIB, metastasized to bone, Grade 2, 11/12 nodes, ER+/PR+, HER2-
Dx
11/15/2021, ILC, Stage IV, metastasized to bone
Hormonal Therapy
11/27/2021 Femara (letrozole)
Targeted Therapy
12/2/2021 Ibrance (palbociclib)
Radiation Therapy
Whole breast: Breast
Surgery
Mastectomy: Left
Chemotherapy
AC + T (Taxol)
Hormonal Therapy
Arimidex (anastrozole)
L
lauri
Joined:
Apr 2006
Posts:
259
Latest activity:
Jan 4, 2022
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Oct 4, 2010 07:29AM
lauri
wrote:
Eventually you'll get an EOB (Explanation of Benefits) that will spell it all out -- sounds like there's a maximum amount BC/BS shows as "reasonable and customary" and then they pay a percentage of that. When I was going through treatment I went on the BC online system and left them email notes asking questions (beats sitting on the phone!) and they generally respond quickly.
From the ashes of disaster grow the roses of success
Dx
3/8/2006, ILC, Left, 6cm+, Stage IIIB, metastasized to bone, Grade 2, 11/12 nodes, ER+/PR+, HER2-
Dx
11/15/2021, ILC, Stage IV, metastasized to bone
Hormonal Therapy
11/27/2021 Femara (letrozole)
Targeted Therapy
12/2/2021 Ibrance (palbociclib)
Radiation Therapy
Whole breast: Breast
Surgery
Mastectomy: Left
Chemotherapy
AC + T (Taxol)
Hormonal Therapy
Arimidex (anastrozole)
