Debbie and Abby

[Guest guest]

Re: BCBS of MI denied appeal

Hi Debbie,

Sorry that I have been quiet for so long. LIfe just gets so busy. is doing really well. We got some very good rounding with his first band, and almost all of the assymetry corrected. His correction with the first band was so good that we almost didn't get a second one. Now that he is one month into his second band, and we are definitely glad that we decided to do it. We are getting some more length with the second band. We are even pretty used to the Cleveland trips. We always go shopping or out to eat while we are there to make it bearable. I think I might actually miss going just a little bit when we are done. Then again, probably not. should be out of his second band by early Nov. I doubt we will be done fighting with the insurance by then though. Please wish me luck with that, I'm sure going to need it.

Take Care,

mom to

banded 3-10-02

MI

Hi :)So good to hear from you again. How is 's little head doing in his band? Have you seen good rounding? How have those looonnngggg drives been going?In our "files" section, "help folder" "insurance issues" there is a letter that says the DOCband is NOT investigational, the letter is great & should help you some.To search our group archives, type in the word or words of what you're looking for, then search.....it will turn up any results with the words you typed in by month. Click the "next" button when you are done with that month. It can take a while, but hopefully you'll find something.I can't recall anyone from MI fighting BCBS. Best of luck in your battle. Please update us on s progress!Debbie Abby's mom DOCGradMI> HI,> > I haven't posted in a long time, but I do lurk about from time to time. My son just turned 1 on 7-19 and is about one month into his second DOC band. BCBS of MI has denied our appeal stating that " This type of service is considered investigational". They go to say that only services approved by BCBS of MI and the Medical Advisory Board of the National BCBS Association are payable. I have two questions? First, has anyone out there had any experience with BCBS of MI? Second, does anyone have any idea how I argue with the investigational label? I know that the FDA has approved the Doc Band so I'm not sure how BCBS can say it is investigational. > > Also, I thought I might find something that could help me in the archives here, but I'm having trouble figuring out how to get to them. Could someone please give me instructions. Thanks in advance for advice for me.> Gladieux> mom of > banded 3-10-02> Monroe, MI> > > > > > > > > > Hello!> > I have started a page to capture links to information on Insurance Company> Policies regarding treating abnormal head shape:> > http://www.plagiocephaly.org/resources/insurance.htm> > If you have information to add, please let me know!> > Regards,> > > <!--> M. , Ph.D.> Webworks & the University of Iowa> Learn more at http://www.KM.net> See the sites at http://www.Webworks.com!> -->> > >

[Guest guest]

:

Thanks for such a great update I doubt you'll miss the Cleveland

commutes once the bad winter weather starts settling in on us.

will be done just in time to beat that! I'm so happy to hear how

well he's progressing.

I was truly just thinking about you, on the front page of our Grand

Rapids Press newspaper tonite is a huge long article about BCBS or

MI. It's basically just local information saying BCBS won't allow

patients to go to Spectrum Hospitals here in GR - Blodgett AND

Butterworth, our 2 main & best hospitals. They will allow admission

under special circumstances, like if any of our other area hospitals

won't treat a specific condition, etc....I was sick after I read

this. Spectrum is the #1 childrens hospital here in town. Gimme a

break! I'm SOOOO happy I don't have BCBS, we had it for a very short

time and had nothing but problems with it. The monthly premium for

family coverage at my husbands work with BCBS costs $800.00.....thank

goodness I have ins. thru my job! And it's not as though people are

getting coverage the insurance should be providing!

Argh, so sorry to get off on a major rant here......I'm really really

sorry you're fighting with your ins., $6,000 for 2 bands is a lot of

money, I hope you'll win your appeals.

Debbie Abby's mom DOCGrad

GR MI

>

> > HI,

> >

> > I haven't posted in a long time, but I do lurk about from

time to

> time. My son just turned 1 on 7-19 and is about one month

into

> his second DOC band. BCBS of MI has denied our appeal stating

that "

> This type of service is considered investigational " . They go to

say

> that only services approved by BCBS of MI and the Medical

Advisory

> Board of the National BCBS Association are payable. I have two

> questions? First, has anyone out there had any experience with

BCBS

> of MI? Second, does anyone have any idea how I argue with the

> investigational label? I know that the FDA has approved the Doc

Band

> so I'm not sure how BCBS can say it is investigational.

> >

> > Also, I thought I might find something that could help me in

the

> archives here, but I'm having trouble figuring out how to get to

> them. Could someone please give me instructions. Thanks in

advance

> for advice for me.

> > Gladieux

> > mom of

> > banded 3-10-02

> > Monroe, MI

> >

> >

> >

> >

> >

> >

> >

> >

> >

> > Hello!

> >

> > I have started a page to capture links to information on

> Insurance Company

> > Policies regarding treating abnormal head shape:

> >

> > http://www.plagiocephaly.org/resources/insurance.htm

> >

> > If you have information to add, please let me know!

> >

> > Regards,

> >

> >

> > <!--

> > M. , Ph.D.

> > Webworks & the University of Iowa

> > Learn more at http://www.KM.net

> > See the sites at http://www.Webworks.com!

> > -->

> >

> >

> >