Guest guest Posted June 10, 2009 Report Share Posted June 10, 2009 From what I remember, Basic option only reimburses for an in-network ortho/helmet, I think 75% (possibly more), with no reimbursement for an out of network provider. At least that is the case in North Carolina where we are. We have the Standard option which is the higher option, and we had 90% reimbursement for in-network and 75% reimbursement for out of network (which Cranial Tech was for us). We got our reimbursement check within 3 weeks of filing our claim, no questions asked (though a letter of medical necessity was required, which we had). Jake-2.5 (DOCBand Grad 9/08) Jordan-5 > > Anyone with this insurance get reimbursed?? Thanks! > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 11, 2009 Report Share Posted June 11, 2009 I have BCBS FEP Standard Option and we got 85% paid for (we paid 15%). We were in network. I would think you would get something from Basic as well. > > Anyone with this insurance get reimbursed?? Thanks! > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 11, 2009 Report Share Posted June 11, 2009 After two denial letters, they are now telling me that we are out of network. But before we started the whole process, the office's secretary called and they told her they were in network....so frustrating! Thanks for the info! > > > > Anyone with this insurance get reimbursed?? Thanks! > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 11, 2009 Report Share Posted June 11, 2009 I don't think that the insurance companies know how to address the cranial bands. We encountered a similar thing. We were first told it would be covered at 50 to 100 percent, depending upon medical necessity. We were then told helmets were an exclusion. Finally, we were told that they were out of network and would not be covered. We could have gone with Hanger and it might have been covered. With all of this, we were told that if we got the helmet without pre-approval, then nothing would be paid. So, we were on hold with 's advanced age. We finally decided to abandon the whole insruance coverage idea, and just went with the STARband so that we could get her banded. We wasted about two weeks because of insurance confusion. , mom to , 21.5 months STARband grad 11/17/08 to 05/11/09 land Re: BCBS FEP Basic Option After two denial letters, they are now telling me that we are out of network. But before we started the whole process, the office's secretary called and they told her they were in network....so frustrating! Thanks for the info!> >> > Anyone with this insurance get reimbursed?? Thanks!> >> Quote Link to comment Share on other sites More sharing options...
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