BCBS Federal Program Basic Option

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I just reviewed my BCBS program and after looking through the directory realize that Hanger is on there as a covered preferred provider. My doctor's all recommended Cranial Technologies though and never mentioned Hanger, the only reason I knew to look and see if they were in there is from this group. Oh well, I guess I can't use that excuse. I will have to come up with something else, I guess. Either way, my son has his band and now it is a fighting game to get reimbursed although I am not holding my breath. Sybilnwilkens2275 <nwilkens2275@...> wrote: Yes I had a similar experience. I have BCBS of North Carolina Federal Employee Program (through the government). The helmet was covered under the plan, it just depended whether I went to an in-network (90% would be covered) or out-of-network (75%) provider. I wanted to go to Cranial Tech, but they were considered out-of-network. I spoke to an insurance specialist out of the Charlotte office. She told me that because they were out of network, that they would not be able to file the claim for me and that I would have to pay up front ($3000) and file the claim myself. I was okay with that. She then told me that her experience has been that BCBS of NC only covers about $600 before the deductible (which is $300), so she said I should expect to only get 75% of $300. I was totally bummed and expecting the worst. So I filed the claim and after about 3

weeks we got a check for $2073, exactly 75% of $2700 (and some odd dollars since we had paid a little towards our deductible). In the insurance specialist's defense, the federal employee plan is different than your basic BCBS, and she had never dealt with the plan before. But I'm thrilled that her prediction turned out to be so wrong. One of the many things I've learned from this whole plagio journey is not to take everything you're told as an absolute truth. I would recommend ALWAYS filing a claim with your insurance even if you're told it won't be covered. Jake-18m (tort resolved/rt plagio/DocBand 7 weeks)>> > > Okay, so my hubby and I were not the most organized when it comes to our insurance. > Our 4 month daughter had

plagiocephaly with right tort. Our doctor recommend we go to > Cranial Tech. for a consultation and least get some neck exercises. We went but not right > away because I was in denial and she had so much hair you couldn't really tell. So we went > and about a month later get got the DOC Band. The insurance specialist with Cranial Tech > said they would check into our insurance and came back to us and said Blue Shield would > not cover it. So we payed up front 3,000 dollars. When we went for Kaylee's 6 month > check at her doctors. Kaylee's doctor couldn't believe I had to pay for the Band and said I > should have told her and she could have recommend another place. I talked to the > insurance girl at > the doctors and she said to write a letter for medical necessity so I did. The insurance also > did not want to pay for a doctors visit we had talking to the doctor

about if they thought > we should go through with the DOC band. They said it was a preexisting condition that > we didn't tell them about when we switched insurances when she was two months old. > Well we got a letter back saying > they would pay for the doctors visit and The DOC Band and we just needed to turn a > receipt in and make a claim. I talked to Cranial Tech and they said Blue Shield has never > payed for a DOC Band. When we called our insurance lady yesterday she said the check > has been issued and we don't even need to make claim. This is so strange!!!! Has > anyone else had this experience? Wow we are super excited to get the 3,000 dollars back. > But we are not holding our breath! > > , mommy of Kaylee, DOC Band for 8 weeks!>

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