Guest guest Posted March 24, 2006 Report Share Posted March 24, 2006 We are new to Doc Band and are sched. to cast on 04/27/06. Cranial Tech told us BCBS will deny our claim. I have a bicornerate uterus, had lo amniotic fluid and my son was breech. Nevermind he is an awesome sleeper causing his oddly shaped head to flatten more. He suffers from moderate plagio & mild tort. I am ready to go to war with BCBS....does anyone have helpful tips to share? Please HELP! We will HAPPILY pay the 3K to improve our son but only after exhausting efforts to make BCBS pay. THANKS everyone! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 24, 2006 Report Share Posted March 24, 2006 We are new to Doc Band and are sched. to cast on 04/27/06. Cranial Tech told us BCBS will deny our claim. I have a bicornerate uterus, had lo amniotic fluid and my son was breech. Nevermind he is an awesome sleeper causing his oddly shaped head to flatten more. He suffers from moderate plagio & mild tort. I am ready to go to war with BCBS....does anyone have helpful tips to share? Please HELP! We will HAPPILY pay the 3K to improve our son but only after exhausting efforts to make BCBS pay. THANKS everyone! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 24, 2006 Report Share Posted March 24, 2006 Hi, Welcome to the group. Check out our files section for some helpful insurance info. Also check out this link: http://www.cappskids.org/PlagioInsuranceHelp.htm Good luck and keep us posted. --- In Plagiocephaly , " jacksonsmominmd " <deezle3@...> wrote: > > We are new to Doc Band and are sched. to cast on 04/27/06. Cranial > Tech told us BCBS will deny our claim. I have a bicornerate uterus, > had lo amniotic fluid and my son was breech. Nevermind he is an > awesome sleeper causing his oddly shaped head to flatten more. He > suffers from moderate plagio & mild tort. I am ready to go to war with > BCBS....does anyone have helpful tips to share? Please HELP! We will > HAPPILY pay the 3K to improve our son but only after exhausting efforts > to make BCBS pay. THANKS everyone! > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 24, 2006 Report Share Posted March 24, 2006 Hi, Welcome to the group. Check out our files section for some helpful insurance info. Also check out this link: http://www.cappskids.org/PlagioInsuranceHelp.htm Good luck and keep us posted. --- In Plagiocephaly , " jacksonsmominmd " <deezle3@...> wrote: > > We are new to Doc Band and are sched. to cast on 04/27/06. Cranial > Tech told us BCBS will deny our claim. I have a bicornerate uterus, > had lo amniotic fluid and my son was breech. Nevermind he is an > awesome sleeper causing his oddly shaped head to flatten more. He > suffers from moderate plagio & mild tort. I am ready to go to war with > BCBS....does anyone have helpful tips to share? Please HELP! We will > HAPPILY pay the 3K to improve our son but only after exhausting efforts > to make BCBS pay. THANKS everyone! > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 24, 2006 Report Share Posted March 24, 2006 Hi! I don't post very often, but wanted to let you know that BCBS of Colorado paid in full for 2 DOC bands for my daughter. No difficulties at all. We absolutely had to have pre-authorization prior to casting - both times. Needed a letter of medical necessity, prescription stating " no substitutions " , and she had to meet very mild measurements required by them. Not sure what state you're in, but you might feel a little more optimistic. Good luck! Tammy Teagan, DOC Grad March 2006 --- In Plagiocephaly , " jacksonsmominmd " <deezle3@...> wrote: > > We are new to Doc Band and are sched. to cast on 04/27/06. Cranial > Tech told us BCBS will deny our claim. I have a bicornerate uterus, > had lo amniotic fluid and my son was breech. Nevermind he is an > awesome sleeper causing his oddly shaped head to flatten more. He > suffers from moderate plagio & mild tort. I am ready to go to war with > BCBS....does anyone have helpful tips to share? Please HELP! We will > HAPPILY pay the 3K to improve our son but only after exhausting efforts > to make BCBS pay. THANKS everyone! > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 24, 2006 Report Share Posted March 24, 2006 Hi! I don't post very often, but wanted to let you know that BCBS of Colorado paid in full for 2 DOC bands for my daughter. No difficulties at all. We absolutely had to have pre-authorization prior to casting - both times. Needed a letter of medical necessity, prescription stating " no substitutions " , and she had to meet very mild measurements required by them. Not sure what state you're in, but you might feel a little more optimistic. Good luck! Tammy Teagan, DOC Grad March 2006 --- In Plagiocephaly , " jacksonsmominmd " <deezle3@...> wrote: > > We are new to Doc Band and are sched. to cast on 04/27/06. Cranial > Tech told us BCBS will deny our claim. I have a bicornerate uterus, > had lo amniotic fluid and my son was breech. Nevermind he is an > awesome sleeper causing his oddly shaped head to flatten more. He > suffers from moderate plagio & mild tort. I am ready to go to war with > BCBS....does anyone have helpful tips to share? Please HELP! We will > HAPPILY pay the 3K to improve our son but only after exhausting efforts > to make BCBS pay. THANKS everyone! > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 26, 2006 Report Share Posted March 26, 2006 Hello, I have just been through the process with BCBS of Arizona.It does seem that some states do cover this but others pull you through every obstacle there is. I appealed at every level only to get denials. I just received the final decision on an external appeal and they upheld the denial. Their reason is based on medical necessity. Which is just crazy considering his doctor who physically examined my son determined the doc band was medically necessary and included letters stating that, but the medical appeals commitee determined that it was not. Hopefully you will have a different outcome but definetly pursue it to every level available. Maureen --- jacksonsmominmd <deezle3@...> wrote: > We are new to Doc Band and are sched. to cast on > 04/27/06. Cranial > Tech told us BCBS will deny our claim. I have a > bicornerate uterus, > had lo amniotic fluid and my son was breech. > Nevermind he is an > awesome sleeper causing his oddly shaped head to > flatten more. He > suffers from moderate plagio & mild tort. I am > ready to go to war with > BCBS....does anyone have helpful tips to share? > Please HELP! We will > HAPPILY pay the 3K to improve our son but only after > exhausting efforts > to make BCBS pay. THANKS everyone! > > > > > > > __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 26, 2006 Report Share Posted March 26, 2006 Hello, I have just been through the process with BCBS of Arizona.It does seem that some states do cover this but others pull you through every obstacle there is. I appealed at every level only to get denials. I just received the final decision on an external appeal and they upheld the denial. Their reason is based on medical necessity. Which is just crazy considering his doctor who physically examined my son determined the doc band was medically necessary and included letters stating that, but the medical appeals commitee determined that it was not. Hopefully you will have a different outcome but definetly pursue it to every level available. Maureen --- jacksonsmominmd <deezle3@...> wrote: > We are new to Doc Band and are sched. to cast on > 04/27/06. Cranial > Tech told us BCBS will deny our claim. I have a > bicornerate uterus, > had lo amniotic fluid and my son was breech. > Nevermind he is an > awesome sleeper causing his oddly shaped head to > flatten more. He > suffers from moderate plagio & mild tort. I am > ready to go to war with > BCBS....does anyone have helpful tips to share? > Please HELP! We will > HAPPILY pay the 3K to improve our son but only after > exhausting efforts > to make BCBS pay. THANKS everyone! > > > > > > > __________________________________________________ Quote Link to comment Share on other sites More sharing options...
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