Guest guest Posted March 13, 2002 Report Share Posted March 13, 2002 Celeste- Hi! I have Regence Blue Shield, PPO, and I'm not sure if it's the same as what you have, but I know it's somewhat affiliated. When my son, , now almost 14 months, got fitted for his helmet at 12 months of age, the people at our hospital told us to not even bother messing with Blue Shield because THEY NEVER PAY. This really scared me, and I prepared myself for the fight of my life. And then when he got his helmet the nurse told me that Regence Blue Cross/Blue Shield had just paid for another child's helmet a couple weeks prior. I had been denied a month before that, and was starting to compile my appeal packet. Well, a couple weeks after, I got something in the mail like an explanation of benefits, and it certainly appears that they paid for my son's helmet. The price of the helmet was listed and under patient responsibility, there was zero, and it looked like they covered all but 50 dollars of the helmet. So I don't know how it differs from state to state, also my husband has this insurance through Boeing, so that might be a factor as well. I wish you good luck, however, and hopefully you won't have to fight! If you do, though, it will be well worth it and your daughter will thank you! Kellie, mom of , born 1/17/01, helmeted 1/17/02! Tacoma, WA Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 13, 2002 Report Share Posted March 13, 2002 Celeste, Sorry, I don't have BCBS, but we have other members who do. Depending upon what plan and what state you are in the coverage is different. I know that some members have received coverage from their BCBS policy. I guess you will know very soon whether or not they will cover. If they deny the claim then you will have the right to appeal the decision. Many, many people have to appeal denials for coverage and the good news is that those appeals are often times overturned! As for the PT I did not have to go through that, but if I did I would probably insist on seeing a PT the first few times at the very least so I could see how the professionals do it!! Good luck and let us know what you hear from the insurance co. Marci (Mom to ) Oklahoma Quote Link to comment Share on other sites More sharing options...
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