Re: Newbie & Insurance hassles/Advanced OrthoPro/Anthem BCBS is giving us the runaround

[Guest guest]

Sash,

I'm so, so sorry about the incredible insurance run-around you are

getting! Now that you actually have a helpful person to talk to on

the phone, I hope you can get some resolution on it.

Here is Kelli's email: kellik@... (Kelli (mom), Luke

(son who used this helmet)

I hope you get a response from her, she was very nice to me with

help, info, and directions and such.

Would you let us know how things progress with your baby getting the

helmet?

Take care,

Christie (Mom to Repo'd Remy)

> thank you for the info about the helmet. can you send me Kelli's

email address?

>

> i'm sorry this is so long, i've been having major insurance

difficulties with Anthem BCBS.

>

> i've made some progress today. it's been over a month since naomi

was diagnosed with brachy & plagio and the medical information has

*finally* been faxed to the right ppl at the insurance company. you

won't believe all the sh!* they've been feeding me.

>

> first, the neurosurgeon office told me not to worry about the pre-

cert/predetermination. 2 weeks later, i found out they hadn't done

anything about getting the proper information to the insurance

company. they actually fought with me about having her medical

records faxed to Anthem BCBS. they told me there wasn't a pre-cert

required but I found out it was a pre-determination. apparently,

there is a big difference. Anthem also gave me 2 different fax

numbers for the information to be sent to. Neuro's office finally

faxed the documents only to have anthem tell us that they didn't fax

the right stuff and needed to send other documents. they sent the

information but when i call Anthem, they say it takes a few weeks to

get into the system. FYI, this is the proper information that

Anthem BCBS wants -

http://www80.anthem.com/jsp/antiphona/bcbs/nav/ilink_pop_native.jsp?

content_id=PW_034017

> hopefully that will save *someone* some time and frustration.

>

> well, they faxed the right stuff on Monday but i forgot to mention

that naomi was being added to my policy from my husbands. that was,

in fact, my fault.

>

> just today i spoke with someone at Anthem again who told me the

information wasn't received and she actually checked the fax

machine! she was the first helpful person i've spoken with there.

she asked if i had their fax number and i said, yes i have 2 of them

but give me yours. she gave me a 3rd and different phone number, it

was actually *her* fax number. i told her the other 2 and she told

me it was administration and didn't know why they gave me those fax

numbers. that explains why i've had to have the drs. fax over 7

documents to them and they only received 1. i called later today

and spoke with her again and she said she forwarded the documents to

the proper people. i asked if i could check in with her about the

status and she said yes.

>

> i've left out quite a few calls here and there. after all, it has

been going on for over a month and i've been calling at least every

other day either Anthem or the drs office. at least today, i know

someone has actually done something to get this pre-determination

rolling. unfortunately, with the way things are going i doubt

they're going to cover her helmet...

>

> sash

>

> Re: Newbie & Insurance hassles/Advanced

OrthoPro

>

>

> Sasha,

>

> I have heard of Advanced OrthoPro! We actually have it listed

in

> the Helmet/Band Database in the Database section of the group.

I

> know of one parent who is no longer active in the group who took

her

> baby there. From what I recall, she was happy with the

treatment

> there. The helmet (back then, at least) was a passive, custom-

made

> helmet that is NOT FDA approved (not sure if that affect

insurance

> coverage or not.) Here is the info from the Database, including

the

> email of the mom who had been there (she provided it to be

contacted

> offlist by any other parents considering this helmet/facility;

why

> don't you try and send her an email?) Her name is Kelli, and

she

> was extremely nice and helpful to me when I was considering this

> helmet for treatment of my own daughter, Remy, since we weren't

too

> far away being that we lived in Kentucky (we ended up using

> repostioning only, no helmet though.)

>

> Indiana

> Local Helmet

> Advanced OrthoPro, (there are three locations in the

Indianapolis

> area)

> 1820 North Illinois Street;

> Indianapolis, IN 46202

> (317) 924-4444

> www.advancedorthopro.com

>

> Would you let me know how your next appt. goes, or if I can help

you

> with researching any other options in your area?

>

> Take care,

>

> Christie (Mom to Repo'd Remy)

>

>

>

> kellik@i... (Kelli (mom), Luke (son who used this helmet)