Re: Update on BCBS!-To Roseann

[Guest guest]

Roseann, I live in Tennessee and work for the State, Dept. of

Environment & Conservation. I have had a long road with BCBS.

First, they had it as being denied, I called and a woman in customer

service told me that it had been processed incorrectly. So, then it

was paid. Great! Then they denied my daughter's visits to the

pediatric neurosurgeon. I appealed, throwing in that they had paid

for the helmet already (dumb me) and they came back and said that

they had paid the helmet by mistake so then they turned around and

took the money back from the helmet place and denied both the helmet

and the dr's visits. I thought about giving up but I went on and

wrote an appeal letter and copied all info and paperwork I received

from my daughter's pediatrician, neurosurgeon, the helmet place,

etc. The letter wasn't anything outstanding. I wrote it while being

mad about being denied stating that " I didn't ask for my child to

have a tummy tuck, facelift, or lipsosuction. I followed the advise

of my daughter's pediatrician and then the neurosurgeon. What do you

consider cosmetic about a child wearing a cranial orthosis helmet? "

I wrote alot of things out of anger and frustration. Then I

submitted it to the state employees' insurance administration. I

opted not to talk to the committee because I was assured that they

would read my letter and look over the material and I got a little

emotional on the phone with the appeals coordinator which might have

helped! lol But I got my letter and they approved the appeal. And

to top it all off, BCBS is paying more this time then before. I

guess they don't have alot of people that will go the extra effort to

appeal. Most people probably just say it was denied and go on and

pay it. Good luck with your case! I hope you have the same outcome

as me!

> , Great News! So glad for you. I'm in the process of

fighting right now with BCBS. Can you tell me which state you are

from? I'm fighting with BCBS of ILLINOIS.

>

> Roseann

> Mom to and Tommy

> South Florida

>

>