Insurance Appeals for Blue Cross Blue Shield of NC or land

[Guest guest]

Hi,

Did anyone out there have to go through the appeals process for the

second time before your insurance company approved payment for the

DOC band? I live in NC but our family's insurance is with Care First

BCBS of land because my husband's job's main office is in

land. The bottom line is that MD has to approve it.

We got all documentation for the first appeal from Cranial

Technologies and did not add anything to it. I wrote a 7 page letter

with the documentation to explain why under our insurance contract

that the DOC band should be covered as " durable medical equipment " .

It was a very thourough letter.

If we are denied again, (we are still waiting) I'm prepared to appeal

again or go to the insurance commissioner of the state of land if

need be. We are very patient and understand this process takes a

long time to get approved if it ever does.

I need some help with " what to do differently " for the second appeal,

if anything. Do I just drop the same packet back into the mail but

with a different letter this time? Or is there other documentation

that could be added. I realize " more " isn't necessarily " better " .

Insurance companies are looking for specific documentation, not a

bunch of fluff. Maybe there is someone out there who has done this

before and could help us. I would be ever so grateful if there is.

Thank you so much!

Judith