Guest guest Posted August 13, 2002 Report Share Posted August 13, 2002 New! Insurance policy links 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 CompanyPolicies regarding treating abnormal head shape:http://www.plagiocephaly.org/resources/insurance.htmIf you have information to add, please let me know!Regards,<!-- M. , Ph.D. Webworks & the University of IowaLearn more at http://www.KM.netSee the sites at http://www.Webworks.com!-->For more plagio info Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 13, 2002 Report Share Posted August 13, 2002 Hi , I recently had my appeal overturned with BCBS of Oregon. They denied me on the basis that the band was " not medically necessary. " In my appeal letter I included information regarding the FDA approval of the DOC band. If you're at the home page on the plagio group's site, you'll click on " Files " then click on " Experimental " and you'll see the BCBS of Illinois Lawsuit/FDA letter file. I also got a copy of the FDA approval of the band from CT in Burbank and included that with my appeal. There's also a great appeal letter in the " Help Folder " after you click on " Files. " It's an appeal letter to Coventry insurance. I formatted my successful appeal letter after that one. Lot's of great info in it. Good luck! , 's mom Southern California --- Gladieux <gladieux@...> wrote: > > New! Insurance policy links > > 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! > --> > > > Quote Link to comment Share on other sites More sharing options...
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