Insurance Denial Overturned

[Guest guest]

I just wanted to let everyone know to keep appealing your insurance

company if you are denied. Our insurance company (Blue Cross/Blue

Shield) denied our first claim despite medical documentation from all

our doctors, specialists, etc. We sent a second packet of new

information and was denied again. At this time, we were told the

insurance company would not allow us to appeal again and the decision

would stand. My husband contacted his benefit department and

explained the situation. We were told to send the benefit department

all the packets/paperwork that we had sent to the insurance company.

(Thank goodness I had made several copies of all packets sent along

with the pictures of Gavin's head from beginning to end.)

The benefit department met and determined we should have NOT been

denied the first time around and they overturned the insurance

companies decision to deny payment on our claim ($2700). The reason

I am telling everyone is so they continue to file claim after claim

with their insurance company even if they are denied the first or

second time. It helped in our case to contact the benefit department

ourselves and fill them in on what was happening. Due to denial

being overturned, our insurance company (within my husband's

department) will request an audit to make sure no one else has been

wrongfully denied payment (S1040 code).

Good luck to everyone as you deal with your own insurance companies.

Griffith

Gavin's mom