Re: DENIED BAND-Trigon BCBS of VA

[Guest guest]

In a message dated 3/16/2001 12:07:15 PM Central Standard Time, theneilsonsil@... writes:

We have BCBS HMO Illinois

, We also have this ins and they covered my sons helmets at 100%. He wore three! Did you get the usual referral and use the particular doctors? Our ped referred us to Univ of Chic to the neurosurgeon. We also went there for PT and that was also paid in full. I just wonder why they paid for our helmets but seem to deny DOC bands. Belinda(Indiana)

[Guest guest]

Hi Monroe,

We have BCBS HMO Illinois and they must send out the exact same form

letter for the initial denial. Is your son getting a DOC Band or

another type? The only reason I ask is because my local CT office

supplied me with a letter written by Tim Littlefield of Cranial Tech

which explained all about how the DOC Band was removed from the

" investigational " list by the FDA and is approved by them.... I was

also lucky enough to find someone else who had been paid in full by

BCBS HMO IL and I think supplying evidence that another member had

been covered was very beneficial in my case!! I don't know how

closely related one state's BCBS to another...but if you can find

someone else who has been covered by Trigon BCBS I THINK that might be

your ace in the hole...but who knows, these insurance companies are so

unpredictable! I just wrote one letter and sent lots of medical

articles I got from the CT office, and I got a letter back within two

weeks, authorizing full payment! It was surprisingly easy for us,

thankfully. I am amazed when I hear the hoops that others have been

made to jump through, sometimes just for partial coverage!!!

Good luck and let me know if there's anything else I can help you

with!!!

- Evan's mom (DOC band 2/06/01)

In Plagiocephaly@y..., thekeenes@m... wrote:

> We received a letter this week from Trigon BCBS of VA denying

> authorization for a band for my 5 month old son who was diagnosed

> with moderate plagiocephaly last month. The reason given

> was " investigational/experimental " .

>

> We are proceding with treatment as we have waited for over two weeks

> for authorization. By the time he is casted and gets his band

> another valuable month will have gone by.

>

> We plan on appealing. Anyone with advice or insight would be

greatly

> appreciated.

>

> Thanks,

>

> Monroe Keene

> Yorktown, VA