Re: HAVE BLUE CROSS BLUE SHIELD FEDERAL EMPLOYEE INS.

[Guest guest]

Oh, that is definitely bad news! I also have BCBS Federal E'ees

Program (PPO), and the CT clinic here in ATL told me that, in their

experience, BCBS denies 50% of the time and pays the other 50%. Talk

about wacky. Anyway, our son was just casted on Fri. so we have no

idea yet whether BCBS will pay our claim. I am having a hard time

getting our pediatrician to follow up on his promise to write a

letter of medical necessity so I am not so hopeful at this point.

Please keep us posted on your appeal, and we will do the same with

respect to our claim process.

Holly &

ATL, GA

> My son is 13 months old and has had his DOC since 7 months.

> Cranial Tech in Paramus called our insurance to see if we need pre-

> authorization and they told them we didn't and that it was covered

> under durable medical equipment. Low and behold we were

> denied...they say it is not medically necessary even though our

> neurosurgeon sent a letter of medical necessity. I have spent days

> calling to find out the specialty of the " medical advisor " making

> these decisions and finally found out that Agnes an RN is making

the

> medical decisions! I am in appeals and will fight this until they

> pay something. I have posted on cranialtech.com under CIGNA case a

> link to view a case in which a family sued CIGNA and won for the

same

> reasons. There is also a case for BCBS in Chicago.

>

> KP

[Guest guest]

Hi KP & welcome to our group!

We're glad to have you. has been in his band for about 6 mos

now, probably 2 bands then? How has his progress been? Good

improvement I hope!

So sorry to hear of your insurance issues. Have you checked out

www.plagiocephaly.org/support, then ins. issues? There is some

helpful info. in there that might help?

We have a lot of members who are also battling their ins. companies.

I'm hoping some of them will give you helpful advice.

Welcome again, we'd love to hear more about & his plagio story.

Debbie Abby's mom DOCGrad

MI

> My son is 13 months old and has had his DOC since 7 months.

> Cranial Tech in Paramus called our insurance to see if we need pre-

> authorization and they told them we didn't and that it was covered

> under durable medical equipment. Low and behold we were

> denied...they say it is not medically necessary even though our

> neurosurgeon sent a letter of medical necessity. I have spent days

> calling to find out the specialty of the " medical advisor " making

> these decisions and finally found out that Agnes an RN is making

the

> medical decisions! I am in appeals and will fight this until they

> pay something. I have posted on cranialtech.com under CIGNA case a

> link to view a case in which a family sued CIGNA and won for the

same

> reasons. There is also a case for BCBS in Chicago.

>

> KP