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Author Topic: blue cross and blue shield of nc changed their approval criteria for treatment  (Read 7346 times)

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Offline outfitter01

  • Member
  • Posts: 9
Hi everybody I just wanted to pass this along:

My insurance denied me twice based on outdated plan criteria from oct 2014. I looked up the criteria that they used and then compared to the most recent version and realized the discrepancy.  They updated their criteria in March and then again in April 2015.

I have resubmitted an appeal but I thought this might be of help to others who are trying to get coverage for their treatment.

https://www.bcbsnc.com/assets/common/pdfs/2015_nc_ideal_prior_authorization_criteria.pdf

Most important make sure you know what your plan covers and their criteria for treatment. Look in your handbook and google terms.  I never even knew to look this up.  I hope this can be another tool in trying to get treatment.
genotype 1A diagnosed in 2004
viral count over 6 mil
positive for cryoglobulins
F2 on fibroscan
AST and ALT vary from 300 plus to norm

 


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