Denied by BC/BS NJ???

[Guest guest]

Marci and ann,

Thank you for your advise. I live in Miami (our insurance is NJ due

to corporate office) and have a casting appointment for our 5 month

old daughter this Thursday with CT. We will pay for the procedure

and continue our dealings with our insurance company. This is all

new to me. I had no idea torticollis (which our daughter has) and

plagiocephaly existed and I would never have imagined that treatment

on a child would be denied by an insurance company.

What we received (after 4 days of asking them to fax it) is a letter

that says that our request for a predetermination of beneifts has

been considered not medically necessary. Is this the same as a

denial letter? I did get the address of their Medical Advisor's

Office which made the decision and was told I could send in an appeal

to them. I was not given a name only a mail station number to

address it to. They said their Medical Advisors Office is made up of

Doctors who reviewed the paperwork on Sofia and made their decision.

Do I prepare the appeal letter now? CT has been very helpful and has

given me some research and articles. I'm not sure what our next step

should be.

Any advise would be appreciated. Thank you.

Barbara