Re: Problems with Claims

[Guest guest]

HOLY MOLEY ! What a huge mess! I have no suggestions what so

ever here. Somebody that has gone out of state for treatment will

sure chime in here. My word, why does this always have to be so

complicated?! Be sure and post the outcome of all this mess.

dustie

--- In Plagiocephaly , " " <sarahhollis@y...>

wrote:

> Hi, this is , 's husband and Hannah's dad. Hannah has

been

> in her DOC Band for 6 1/2 weeks now and I have been having a

problem

> with Blue Cross and the claim for Hannah's DOC Band. The closest CT

> is in Connecticut and we live in Massachusetts, so we have driven 3

> hours to Conn. every week since the casting to have the best.

> Because we are out of our network, the claim has to be submitted to

> Blue Cross of Connecticut and they will forward it to Blue Cross of

> Mass.

> I have called BC of Mass. every other, if not everyday, and they

> say they don't have the claim. I have called at CT and she

> has submitted the claim over and over and over to BC of Conn. I

> finally called BC of Conn. this morning and they have no idea who I

> am, what my claim is, etc. And if you aren't one of their

> subscribers they leave you out in the cold.

> So after I got off the phone with BC of Conn., I called BC of

> Mass. back and they suggested I have CT call them directly and

> submit the claim over the phone. When mentioned this to

> at CT, she said that CT is contractually obligated to bill

> the state where the service was provided. She then said she would

> call to check the claim and resubmit it again, if needed.

> Does this make any sense to anyone that they have to include the

> middle man (in this case - BC of Conn.) and does anyone have any

> suggestions as to what we can do to speed this up? Hannah only has

> another month or so in her DOC Band and it's been recommended that

> we get a second. We are paying out of pocket now and can't afford a

> second out of pocket, so we're trying to speed things up to see if

> BC is going to help or not. Ultimately, it is there decision that

> will make ours. Any suggestions are appreicated and welcome.

[Guest guest]

Is there any way you can file the claim yourself? Our previous

insurance company required that all out of network claims be self

filed. We just downloaded claim forms from the web site and filled

them in.

Randi, mom of STARbanded 5-22-03

> > Hi, this is , 's husband and Hannah's dad. Hannah has

> been

> > in her DOC Band for 6 1/2 weeks now and I have been having a

> problem

> > with Blue Cross and the claim for Hannah's DOC Band. The closest

CT

> > is in Connecticut and we live in Massachusetts, so we have driven

3

> > hours to Conn. every week since the casting to have the best.

> > Because we are out of our network, the claim has to be submitted

to

> > Blue Cross of Connecticut and they will forward it to Blue Cross

of

> > Mass.

> > I have called BC of Mass. every other, if not everyday, and

they

> > say they don't have the claim. I have called at CT and

she

> > has submitted the claim over and over and over to BC of Conn. I

> > finally called BC of Conn. this morning and they have no idea who

I

> > am, what my claim is, etc. And if you aren't one of their

> > subscribers they leave you out in the cold.

> > So after I got off the phone with BC of Conn., I called BC of

> > Mass. back and they suggested I have CT call them directly and

> > submit the claim over the phone. When mentioned this to

> > at CT, she said that CT is contractually obligated to

bill

> > the state where the service was provided. She then said she would

> > call to check the claim and resubmit it again, if needed.

> > Does this make any sense to anyone that they have to include

the

> > middle man (in this case - BC of Conn.) and does anyone have any

> > suggestions as to what we can do to speed this up? Hannah only

has

> > another month or so in her DOC Band and it's been recommended

that

> > we get a second. We are paying out of pocket now and can't afford

a

> > second out of pocket, so we're trying to speed things up to see

if

> > BC is going to help or not. Ultimately, it is there decision that

> > will make ours. Any suggestions are appreicated and welcome.

[Guest guest]

Yup, that is quite the mess. I too go to CT in Connecticut & am

with & fighting BCBS as we speak! If it makes you feel better we

live in Conn & they still claim out of network. we were initially

told that they would cover 70% because they had changed their policy

& that our boys measurements were " severe " , now we get this

rejection letter that they are covering NOTHING! So I called them

today & they said it was cosmetic & that's why it is denied & she

said they never said it was approved, so now they are " reprocessing

it " which will take another 7-10 days (already been over 6 weeks!!!)

Our boys have been DOCbanded for 6 wks & are also recommending a 2nd

band for both. Whether or not they cover is a HUGE decision on

whether to go through with the 2nd DOC band. It is SOOO

frustrating, I was told to keep on them & harassing them. But with

such little time left for the 2nd band I don't to waste time

fighting when they can be getting treatment. Sorry with all this

babbling, I just wanted to tell you that you are not alone we are

fighting the same company.

Good luck with your fight & decisions

Tricia

Braeden & Spencer (DOC banded 5-16)

--- In Plagiocephaly , " " <sarahhollis@y...>

wrote:

> Hi, this is , 's husband and Hannah's dad. Hannah has

been

> in her DOC Band for 6 1/2 weeks now and I have been having a

problem

> with Blue Cross and the claim for Hannah's DOC Band. The closest

CT

> is in Connecticut and we live in Massachusetts, so we have driven

3

> hours to Conn. every week since the casting to have the best.

> Because we are out of our network, the claim has to be submitted

to

> Blue Cross of Connecticut and they will forward it to Blue Cross

of

> Mass.

> I have called BC of Mass. every other, if not everyday, and

they

> say they don't have the claim. I have called at CT and she

> has submitted the claim over and over and over to BC of Conn. I

> finally called BC of Conn. this morning and they have no idea who

I

> am, what my claim is, etc. And if you aren't one of their

> subscribers they leave you out in the cold.

> So after I got off the phone with BC of Conn., I called BC of

> Mass. back and they suggested I have CT call them directly and

> submit the claim over the phone. When mentioned this to

> at CT, she said that CT is contractually obligated to bill

> the state where the service was provided. She then said she would

> call to check the claim and resubmit it again, if needed.

> Does this make any sense to anyone that they have to include

the

> middle man (in this case - BC of Conn.) and does anyone have any

> suggestions as to what we can do to speed this up? Hannah only has

> another month or so in her DOC Band and it's been recommended that

> we get a second. We are paying out of pocket now and can't afford

a

> second out of pocket, so we're trying to speed things up to see if

> BC is going to help or not. Ultimately, it is there decision that

> will make ours. Any suggestions are appreicated and welcome.

[Guest guest]

-

I am only mildy familiar with BCBS, as it is not my insurance but I

have had to help families with them in the past in my job. My only

suggestion, and you may have already done this, is to STOP dealing

with the front-line people in claims/customer service and request to

talk with supervisors. My other suggestion would be to call you

state department of insurance and see if they could provide any

assistance to you. Don't know if either of these things will help -

but hope things get better for you!

Debbie ( C's mom DOCbanded 4-29-03, also getting ready for

band #2)

--- In Plagiocephaly , " " <sarahhollis@y...>

wrote:

> Hi, this is , 's husband and Hannah's dad. Hannah has

been

> in her DOC Band for 6 1/2 weeks now and I have been having a

problem

> with Blue Cross and the claim for Hannah's DOC Band. The closest

CT

> is in Connecticut and we live in Massachusetts, so we have driven

3

> hours to Conn. every week since the casting to have the best.

> Because we are out of our network, the claim has to be submitted

to

> Blue Cross of Connecticut and they will forward it to Blue Cross

of

> Mass.

> I have called BC of Mass. every other, if not everyday, and

they

> say they don't have the claim. I have called at CT and she

> has submitted the claim over and over and over to BC of Conn. I

> finally called BC of Conn. this morning and they have no idea who

I

> am, what my claim is, etc. And if you aren't one of their

> subscribers they leave you out in the cold.

> So after I got off the phone with BC of Conn., I called BC of

> Mass. back and they suggested I have CT call them directly and

> submit the claim over the phone. When mentioned this to

> at CT, she said that CT is contractually obligated to bill

> the state where the service was provided. She then said she would

> call to check the claim and resubmit it again, if needed.

> Does this make any sense to anyone that they have to include

the

> middle man (in this case - BC of Conn.) and does anyone have any

> suggestions as to what we can do to speed this up? Hannah only has

> another month or so in her DOC Band and it's been recommended that

> we get a second. We are paying out of pocket now and can't afford

a

> second out of pocket, so we're trying to speed things up to see if

> BC is going to help or not. Ultimately, it is there decision that

> will make ours. Any suggestions are appreicated and welcome.

[Guest guest]

,

First, Hannah looks great - I am so impressed with her

improvement!!! We are going to CT in NJ, and working with as

well, b/c our insurance, United Healthcare, is confused and thinks

they have a contract with CT when they don't. In the interim, we are

out of pocket over $1,200 so far, so I know where you are coming

from. I call UHC at least 2x a week now to keep on top of the status

of the claim, and unfortunately, that is my only suggestion to you.

Keep calling and being the squeaky wheel, so to speak. Hang in

there, and know you and are doing the right thing for Hannah -

she is adorable and is looking great!!!

Kerrri

Mom to , almost 7 mos and DOCbanded 5/9/03

--- In Plagiocephaly , " " <sarahhollis@y...>

wrote:

> Hi, this is , 's husband and Hannah's dad. Hannah has

been

> in her DOC Band for 6 1/2 weeks now and I have been having a

problem

> with Blue Cross and the claim for Hannah's DOC Band. The closest CT

> is in Connecticut and we live in Massachusetts, so we have driven 3

> hours to Conn. every week since the casting to have the best.

> Because we are out of our network, the claim has to be submitted to

> Blue Cross of Connecticut and they will forward it to Blue Cross of

> Mass.

> I have called BC of Mass. every other, if not everyday, and they

> say they don't have the claim. I have called at CT and she

> has submitted the claim over and over and over to BC of Conn. I

> finally called BC of Conn. this morning and they have no idea who I

> am, what my claim is, etc. And if you aren't one of their

> subscribers they leave you out in the cold.

> So after I got off the phone with BC of Conn., I called BC of

> Mass. back and they suggested I have CT call them directly and

> submit the claim over the phone. When mentioned this to

> at CT, she said that CT is contractually obligated to bill

> the state where the service was provided. She then said she would

> call to check the claim and resubmit it again, if needed.

> Does this make any sense to anyone that they have to include the

> middle man (in this case - BC of Conn.) and does anyone have any

> suggestions as to what we can do to speed this up? Hannah only has

> another month or so in her DOC Band and it's been recommended that

> we get a second. We are paying out of pocket now and can't afford a

> second out of pocket, so we're trying to speed things up to see if

> BC is going to help or not. Ultimately, it is there decision that

> will make ours. Any suggestions are appreicated and welcome.