Help getting paid on Anthem BCBS (California) Transplant Travel Claim

Posted by ken0228 @mayo2go, Jul 27, 2023

Hi all,

Not sure if this is the right group to ask the question. But, I am frustrated in dealing with Anthem BCBS (CA) regarding my travel claim for traveling to Mayo Clinic AZ due to my Kidney Transplant evaluation in Jan 2023.

Before traveling Anthem Member Service reps (many) confirm to me that I have the travel benefit covering up to 10K, and there is no pre-authorization for travel.

Then after my Jan evaluation in AZ, I file a travel claim with Anthem---which was actually submitted through an Anthem Member rep, because on the Travel claim form downloaded from Anthem.com, there is no information as to where to submit the form to---no address and no email address. Isn't that funny?

Then, the claim got denied saying I need pre-authorization. It does not make any sense because Mayo was already gotten the authorization for doing a kidney transplant evaluation from Anthem.

After the claim gotten denied, I called Member Service again; the rep re-submitted again. Then, a few days later, the claim was returned saying the claim should be handled by the transplant team, but I have no contact information for the transplant team.

I am so so frustrated dealing with Anthem regarding the travel claim for the transplant. I want to know if anyone here can shed some light on this based on your own experience. I am sure there are a lot of out-of-state, Anthem-covered, Mayo patients who are in the same boat as I am.

Many thanks!

Ken

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aprilradek | @aprilradek | Jul 30, 2023

Hi Ken,
I suggest calling the office of your state rep. I have found them to be very helpful and will call blue cross on your behalf. I am in California so I am not sure if your state reps provide the same support. I have anthem blue cross, I get it. Our healthcare system is a mess.
april

aprilradek | @aprilradek | Jul 30, 2023

Oops I just read that you are also in California call your state rep for sure-

Rosemary, Volunteer Mentor | @rosemarya | Jul 30, 2023

@mayo2go, Hi, Ken, I hear you saying that the claim should be handled by the transplant team, and that you have no contact information for the transplant team. Since you were tested at Mayo Clinic Kidney Transplant Department, in Arizona, I want to share the contact information with you. You can call or email.
https://www.mayoclinic.org/departments-centers/kidney-transplant/contact-us/occ-20209485

ken0228 | @mayo2go | Aug 2, 2023

In reply to @rosemarya "@mayo2go, Hi, Ken, I hear you saying that the claim should be handled by the transplant..." + (show)

Thanks a lot.

Ken

ken0228 | @mayo2go | Aug 2, 2023

In reply to @aprilradek "Oops I just read that you are also in California call your state rep for sure-" + (show)

Hi April,

Thanks a lot. What do you mean by "state rep"? Is he/she an Anthem service rep or someone else?

Ken

aprilradek | @aprilradek | Aug 2, 2023

Hello Ken,

I mean your California state rep- who you vote for to represent you in Sacramento, mine are Assemblymember Dawn Addis and Senator John Laird. They are supposed to be your advocate. I had to contact mine when my husband was charged for an ambulance ride. I just contacted them again as my insurance will not cover meds to bump up my white blood cell count. I have found them to be very helpful, they will contact the insurance company with you on the line with them. Sometimes they have access to people at the top-
Good Luck
April

calisteph6 | @calisteph6 | Feb 15 1:22pm

Hi Ken,

Did they ever approve it? I called today and they told me it's only for the actual procedure and not for the evaluation but they didn't seem very sure. I was googling to find out if anyone else went through this and I found your post.