partial insurance coverage

[Guest guest]

Hi everyone! My son is 5 months old and is in his 6th week of

DOCband treatment. He is doing great and I can only say that we are

so grateful that our pediatrician took this issue seriously and that

we are lucky to be close to a CT facility.

My question is this: when I first contacted our insurance company

(BCBS), I was given a general coverage estimate of 80%. This was for

Durable Medical Equipment. OF COURSE, I didn't record who I spoke to

and I have nothing in writing, so I am fully aware that that

estimate is basically meaningless at this point in time.

We called BCBS another time to find out what our coverage was and

were told that they needed a code. We didn't have a code so we let

it go. Then CT told us that our BCBS coverage typically pays $900.

As of today, our claim was approved for approx. $1600. Should I be

happy with that, or should I appeal for more coverage? I see so many

parents who were 100% denied and I don't want to push my luck if

this is a reasonable coverage amount. However, part of me wants to

educate our provider so that even if we don't get full coverage,

they will recognize this as a growing problem and not only increase

their coverage for other babies but also educate their physicians

and patients.

Any advice is welcome. Thanks so much!