Blue Cross Blue Shield

[Guest guest]

Im STILL waiting to hear back from BCBS about authorization for the DOC band.

Any body have the same insurance? Did they cover the band for you. My

policy is investigating " prexisting clause " term.............how in the world

can plagio be a prexisting condition? Just wondering if anyone has the same

insurance and what kind of experience they've had. Thanks for the help.

Heidi & Luke (still waiting)

[Guest guest]

i have personal choice and i just got that form. i already got the

starband with the assumption that it would be covered. i even thought

i was- up until i got this form. i don't think it will be a problem

because they usually cover everything. good luck

> Im STILL waiting to hear back from BCBS about authorization for the

DOC band.

> Any body have the same insurance? Did they cover the band for you.

My

> policy is investigating " prexisting clause " term.............how in

the world

> can plagio be a prexisting condition? Just wondering if anyone has

the same

> insurance and what kind of experience they've had. Thanks for the

help.

>

> Heidi & Luke (still waiting)

[Guest guest]

We have BCBS PPO. They initially denied our claim because " it wasn't

covered by our policy and it was not medically necessary. " We

appealed and won. We're in Kansas City.

and

Parents to Seth

> > Im STILL waiting to hear back from BCBS about authorization for

the

> DOC band.

> > Any body have the same insurance? Did they cover the band for

you.

> My

> > policy is investigating " prexisting clause " term.............how

in

> the world

> > can plagio be a prexisting condition? Just wondering if anyone

has

> the same

> > insurance and what kind of experience they've had. Thanks for

the

> help.

> >

> > Heidi & Luke (still waiting)

[Guest guest]

We have BCBS-HMO so we had a Big fight to get them to cover my

daughter's STAR band. We got up to right before the 2nd appeal and

they finally approved her band. They have not paid yet but did

approve it. The final thing that changed the medical director's mind

was I sent pictures of her misshappen head!!! To speed the process I

e-mailed some and sent others!!!If you send them reg mail they always

seem to lose them!! If you get to the appeals process don't get

discouraged, FIGHT!! The harder that you fight, I think they start to

realize you will not go away. Good luck!!

Amy & Abigail(banded 1/12/2001)

[Guest guest]

> how in the world

> can plagio be a prexisting condition?

>

If your child is born with a flat head (as I suspect you think yours

was) it is considered pre-existing. I would aim at proving this. Check

all of your newborn pix. Does baby always face the same way? If the

flat spot wasn't there, perhaps you could prove that torticollis existed

at birth (causing the head to stay in one position, causing the flat

spot).

Kendra

Hashworth73@... wrote:

> Im STILL waiting to hear back from BCBS about authorization for the

> DOC band.

> Any body have the same insurance? Did they cover the band for you.

> My

> policy is investigating " prexisting clause " term.............how in

> the world

> can plagio be a prexisting condition? Just wondering if anyone has

> the same

> insurance and what kind of experience they've had. Thanks for the

> help.

>

> Heidi & Luke (still waiting)

>

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[Guest guest]

We have federal employees bcbs and have got our star band after Christmas.

To date we have not been denied. We have a diagnosis on record from May for

torticollis and have been in physical therapy on a regular basis. My

orthotist is handling the claim. We also have recommendations for helmet

therapy from both a cranial-facial plastic surgeon and pediatric

neurosurgeon. Federal employees do not have a " pre-existing " clause so

hopefully things will go smoothly. Good luck to you and if I can provide

any other info on bcbs let me know

Polly

----- Original Message -----

From: <Hashworth73@...>

<Plagiocephalyegroups>

Sent: Friday, January 19, 2001 7:35 PM

Subject: Blue Cross Blue Shield

> Im STILL waiting to hear back from BCBS about authorization for the DOC

band.

> Any body have the same insurance? Did they cover the band for you. My

> policy is investigating " prexisting clause " term.............how in the

world

> can plagio be a prexisting condition? Just wondering if anyone has the

same

> insurance and what kind of experience they've had. Thanks for the help.

>

> Heidi & Luke (still waiting)

>

>

[Guest guest]

Thanks Polly, hopfully you will continue to have good luck. Im suppose to be

getting an answer today. Keeping my fingers crossed.

Heidi

[Guest guest]

Dear Sheryl,

I think our insurance is PPo but it is very closely regulated by my husbands company which is International Union of Operating Engineers Local 150. I am not really sure if they were the ones that approved it or if it went to the insurance for approval. I believe they are in a way self insured, that the IUOE picks up part of the tab for what the insurance doesn't cover under what they call a Welfare Fund. The orthotist took care of all that insurance approval stuff for us. We had the Dr and Pt write medical necessity letters and the orthotist made all the calls and filled out paperwork. I did talk to someone else a while ago that also had BCBS of IL as a PPO and the employer was Mcs and she told me about the lawsuit. I believe that her helmet was not covered. So it makes me wonder if it depends on the employer also. I hope this helps. The process was actually very easy for us. Let me know if you need any help, I will do the best I can.

We were going to go to CT in Naperville or Chicago but decided to go to an orthotist in our town that does Starbands because otherwise we would've had a long drive. We live in Mishawaka, IN and are out of network for BCBS anyway but they didn't give us any trouble.

Good Luck,

Sara &

Starband