insurance question for you guys!

[Guest guest]

Okay, here's the deal. We have Regence, and a couple months ago received our denial letter from them. I have until the end of this month to appeal the claim. I have been working on my appeal. However, at 's appointment to receive his helmet, the nurse practitioner told me that someone had just been finally approved through Regence Blueshield.

Well, today, I got something from them in the mail, and it is one of those forms that says, "Explanation of Benefits. This is not a bill." And below it is all the info about where the services were rendered, Children's Hospital, and the date of Jan 17, 2002 matches up with the day he received the helmet. Under services rendered, it says, "Misc Hospital Services, billed $1300.00. Now, mind you, 1300 is the cost of the helmet! However, there is an extra 200 bucks for their services like the adjustments and stuff like that, but anyway, I read on further, and under "Allowed," it says $1235". Oh, and before I forget, there is an additional 30 dollar charge for the chin strap, so, totaled onto the first amount, the total paid amount is 1263! Am I going nuts or did Regence just pay for my son's helmet? It's gotta be too good to be true, but I don't want to call them and ask. I think I'll just leave things as they are and wait until I see something that states something otherwise.

Have any of you ever gotten anything like this from your insurance companies?

Kellie, Mom of , helmeted 1/17/02

Tacoma, WA