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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

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 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
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