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Re: BCBS / to Jill

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Jill,

Also, Check out this site www.cappskids.org they have a section that

has appeal letters under each reason for denial. Do all the research

you can and use that in your appeal letter check other insurance

websites to see if they have coverage for the bands and use that in

your letter that other major insurance companies are paying. you can

also go through your employer for help the human resource department

can sometimes help you fight they have a relationship with some of

the insurance reps directly. Whatever you do don't give up the fight

that is what the insurance company's want you to do after your 1st

denial and most people do.......through this site see if you can

find someone that BCBS paid for and ask them if you can use their

name and get all the info you can from them it will help if you have

to go the discrimination route and at least scare the insurance

company. These insurance companies are so unfair.......GOOD LUCK

(DOC band grad " 03 " Dallas)

> > > > Hey there!

> > > > Well, we finally received our denial letter from BCBS TX.

> > > > Geesh...took them long enough! I have already started our

> appeal

> > > > letter. Thanks to all the information in the files and links

> > > section

> > > > plus the CT appeal packet, I hope to make a pretty good

case.

> > They

> > > > denied it because they view the treatment as

> > > > investigational/experimental. I called them to get a further

> > > > explaination. It appears that they would cover it if he had

> > > surgery,

> > > > but view it as cosmetic since he did not. Give me a break!!

> > > >

> > > > Well, I will give a quick update on . He has been

doing

> > > great

> > > > in his DOC band. We have already seen quite a bit of

progress.

> > He

> > > has

> > > > had 2 adjustments already and at both quite a bit was shaved

> off

> > > to

> > > > allow for more growth. Our next appt is next Monday. This

has

> > been

> > > > such a positive experience, (well, other than the insurance

> > issue)

> > > > I am so glad we did it! I added a couple of pics to

's

> > > folder

> > > > last week. It is under Matt C.

> > > >

> > > > Thanks for all of your support---This board has been such a

> > > blessing

> > > > to me. I have learned so much from what I have read here.

> > > >

> > > > Jill and (7 mos, DOC 5/20)

> > > > Dallas

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