Re: BC/BS NJ - Insurance Question

[Guest guest]

Ask them to fax you something that outlines the guidelines for filing appeals.

Without seeing the 180 day thing in writing I would be skeptical. I'm positive

that they have written guidelines about appeals.

Marci (mom to )

Oklahoma

[Guest guest]

Marci,

After speaking to 3 people and 35 minutes later they tell me that

they have no written guidelines for appeals. They asked that I send

them a letter requesting them to send me something.

No supervisor was available so I left a message. I guess I'll call

back this afternoon if I don't get a call back.

FRUSTRATING!

Barbara

Sofia & Catalina

-- In Plagiocephaly@y..., marcisch@a... wrote:

> Ask them to fax you something that outlines the guidelines for

filing appeals. Without seeing the 180 day thing in writing I would

be skeptical. I'm positive that they have written guidelines about

appeals.

>

> Marci (mom to )

> Oklahoma

[Guest guest]

Barbara -

Wow - that is frustrating! Whenever you get ahold of a supervisor I would

insist that they send you something in writing whether or not they have

anything standard. You really need it in writing so you don't get a new story

later after it's too late!

Marci (Mom to )

Oklahoma

[Guest guest]

Hi,

BCBS of Oregon gave me 60 days to appeal. I requested

the appeal paperwork over the phone after I received

their denial letter and in the appeal paperwork it

stated the response time frame. I had to send in my

appeal letter and backup with the appeal form they

sent me to fill out.

, 's mom

Southern California

--- catasofia2002 <catasofia2002@...> wrote:

> Hi,

>

> I'm preparing our appeals letter and package because

> they denied

> coverage for the DOC band based on " not medically

> necessary " .

>

> Blue Cross Blue Shield of New Jersey does not issue

> out procedures

> manuals. All we have is a 3 page document that says

> what they cover.

>

> I thought we had 30 days to appeal but BC/BS says we

> have up to 180

> days? Our 30 days are up on Friday and I'm rushing

> to finish the

> package. Does 180 days sound right? Maybe I should

> ask them to fax

> me something saying that we have the 180 days.

> Would they do that?

> They are not very helpful.

>

> Help.

>

> Barbara (Sofia & Catalina)

>

>

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