(no subject)

[Guest guest]

I would like to hear from anyone who has appealed an insurance decision and

won. My daughter is going to NY in December and Blue Cross has denied the

referral. I'm going to take her anyway; however, I will have to pay 20% of

all the tests done. I'm also concerned that if NY recommends surgery I will

have to pay 20% of that because it is out-of-network benefits and they did

not approve the referral.

I called Blue Cross and the only response I got was that they could not tell

me why it was not approved. When I stated that I could provide them with

articles on ACM and how a CINE MRI was an important tool to use to diagnosis

adequate flow of CSF fluid, and we do not have that capability in MIchigan,

she just stated that there was nothing she could do.

I had surgery in October in NY and Blue Cross approved the referral and

surgery right away. I'm a little confused as to why they approved my

referral and will not approve my daugther's. Anyone have any suggestions of

what I do from here.

Thanks

Terri in MI