FAQs

Get answers to frequently asked questions.

Get Answers

Log in to our community to ask questions, rate articles, comment and more.


Facebook Twitter YouTube LinkedIn

Home » Questions And Answers » Why is Corneal Collagen Crosslinking (0402T) not covered by BCBSIL even though it is FDA approved and covered under other BCBS state plans?

Why is Corneal Collagen Crosslinking (0402T) not covered by BCBSIL even though it is FDA approved and covered under other BCBS state plans?

JonScruggs
over 6 years ago

Apparently this procedure is deemed "experimental" according to the BCBSIL agent I spoke to. It's been FDA approved since May 2016, and is covered by at least eight other BCBS plans,

().

Would BCBSIL rather pay for a much more expensive corneal transplant instead? Why are other BCBS plans covering this and IL does not?

Parents Reply
  • 0 over 6 years ago in reply to JonScruggs
    You may contact the Blue Cross and Blue Shield of Illinois (BCBSIL) Claim Review Section, P.O. Box 2401, Chicago, Illinois 60690. If, after investigation, BCBSIL determines that the claim (or portion of a claim) was correctly denied, you may appeal the denial as detailed below.

    Under federal law, you are entitled to a full and fair review of the denied claim. Appeals must be made in writing within 180 days from the date you receive notice that your claim has been denied. You may submit written comments, documents, records and other information related to the claim for benefits with your appeal. You should also include any clinical documentation from your physician that would substantiate coverage of the denied claim.

    You will receive a written decision within 60 days of receipt of your appeal request.

    ~ Heather
Children
Related

Blue Cross and Blue Shield of Illinois, a Division of Health Care Service Corporation,
a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association

© Copyright 2024 Health Care Service Corporation. All Rights Reserved.

Telligent is an operating division of Verint Americas, Inc., an independent company that provides and hosts an online community platform for blogging and access to social media for Blue Cross and Blue Shield of Illinois.

Adobe pdf icon File is in portable document format (PDF). To view this file, you may need to install a PDF reader program. Most PDF readers are a free download. One option is Adobe® Reader® which has a built-in screen reader. Other Adobe accessibility tools and information can be downloaded at https://access.adobe.com.

leaving site icon You are leaving this website/app ("site"). This new site may be offered by a vendor or an independent third party. The site may also contain non-Medicare related information. Some sites may require you to agree to their terms of use and privacy policy.

Powered by Telligent