Blue Cross Blue Shield of North Carolina are misleading bastards.

This post started as a cheery update of how I'm doing, but between when I started writing and when I finished, I got some bad news. So that post is coming later.

Blue Cross Blue Shield of North Carolina only wants to reimburse me for $2,000 of my $16,000 worth of pre-approved jaw surgery. Here's how my conversation with them went:

Me: Hi there! I wanted to know how much you'll be reimbursing me for my recent massive jaw surgery? The surgeons required payment up front, so I took out a $16,000 loan to cover it. I'd like to pay that back as soon as possible.

BCBS: Let's have a look... ah yes, you'll be reimbursed $2,000.

Me: What? But I thought my health insurance plan covered 70% of out of network fees with a $1,000 deductible.

BCBS: Yes, but we only allow $4,000 for this surgery. We only cover 70% of the $4,000 after your $1,000 deductible.

Me: That's a large gap. Why wasn't I told about this?

BCBS: It says it somewhere in your plan.

Me: I mean why didn't anyone tell me that Blue Cross Blue Shield would only "allow" for a quarter of the cost of this surgery?

BCBS: We have an estimator thingy somewhere in the bowels of our site.

Me: No one told me about that. I didn't even know what "allowable" meant until now. Heck, I didn't even realize it was in my plan!

BCBS: Really? Too bad. But how were we to know that your surgeon would charge you so much. I bet they were trying to pull the wool over your eyes, hiking up their prices and sticking you with the bill. We fight on behalf of--

Me: But you knew how much it cost.

BCBS: Pardon?

ME: I submitted a detailed price list for this operation six months ago for pre-approval. I went through six months of appeals. I went to the your headquarters in Chapel Hill on a work day to plead my case. I went through hell and back over $2,000? You would really waste the time of dozens of people and professionals over two thousand dollars?

BCBS: Well, the appeals people don't really know what anything costs. You should have used the estimator.

Me. Please pass my suggestion to your superiors that this fabled estimator needs to be mentioned somewhere on the procedure approval letter.

BCBS: We estimate that this procedure should cost only $4,000. That's how much our in-network people would have done it for.

Me: If I recall, I did in fact try to see an in-network surgeon associated with a university. His office was dark, his staff barely there, and he merely "eye-balled" my jaw instead of actually measuring it. And he never returned any of my calls, and believe you me, I hounded him. (Sounds to me like the in-network surgeons would rather be out-of-network or not bother at all.)

Listen, I work with a girl who saw a similar "cheap" surgeon. The state sent her there. He butchered her face. Her teeth were off by a full inch. She had to see another surgeon who performed the procedure yet again after which she was wired shut. Now she looks like the bionic woman in her dental x-rays. She went through this horrible, painful, disruptive surgery twice, and she didn't need to. It ended up costing everyone.

This is not a four thousand dollar procedure. The equipment they used to measure my face and make my splint, the number of staff members who had to be there all along the way, their ability to return phone calls, I assure you, it was worth every penny. The final bill was less than the estimate even.

I did my homework. I got estimates from several surgeons. They were all in the same price range, and he's not driving a Ferrari, so stop suggesting he's pulling the wool over my eyes when your own company officials get Christmas bonuses.

I've gathered estimates from many surgeons. This is how much it costs.

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Okay, I didn't say it like that, and he wasn't an asshole, but that's the gist of it.

Yes, I plan to appeal. And appeal. And appeal. I'm going to waste as much of their time as possible now. They have wasted plenty of mine.