Re: Blue Cross Blue Shield of MA

[Guest guest]

Hi ,

I don't know about the insurance, but most of the gh companies have a

program for people who have insurance that won't cover gh. Sometimes

it is provided free until your insurance gives in. Also call MAGIC and

tell them, they know how to help!!!

Blessings,

Carmen, Mom of the ever growing and soon to be starting puberty Storm,

Age 10 1/2

[Guest guest]

Hi ,

I live in NH. I know very little about BCBS. I have not heard of

anyone being denied growth hormone from them. Did they give an

explanation?

Have you filed an appeal? Also, you might want to get your ped/endo

to write a letter to submit with your appeal explaning why Jillian

needs growth hormone. A letter from your pediatrician might help but

the ped/endo letter will carry more weight. You need to become a

little bit of a lawyer and private investigator.

I find it very odd that after 22 months they suddenly deny you GH. It

is important to find out why. What were the mitigating circumstances

that prompted this action?

In the meantime, if you need growth hormone, contact the growth

hormone supplier. Often they have a " bridge " program that will supply

growth hormone for a few months while you get this resolved.

Also, is there any chance you switch health insurance companies? We

used to have Harvard Pilgrim and never had a problem with them

regarding growth hormone.

Like with the school system or any other possible legal battle, get

everything in writing.

Sorry I can't be more help.

I hope this helps.

Ken M

>

> Hi Guys,

>

> Hope you are all doing OK. I have been away from the boards for a

> while because of school issues which has been consuming me for

> months. Just as I get that issue sorted out, I get informed that my

> new insurance company (Blue Cross Blue Shield of MA) have denied

> growth hormone coverage for Jillian. She has been on the drug for

22

> months and has done so well since starting it. Anyone out there

with

> BCBS of MA and a child with RSS get approved for coverage. If so,

how

> did you get approval?

>

> Jillie is doing great. She still needs a little oxygen and some GT

> feeds overnight but is otherwise forging ahead. She is walking

quite

> well now and has started walking up the stairs. She is eating 700

to

> 1000 cals a day by mouth and her variety of food is up (feeding

> therapy!!). Her favorite foods are spanakopita, hummus, tomatoes,

> pizza and dora cookies. She is picking up sign language quite well

so

> is less stressed with communication. Errol and I are taking weekly

> lessons and have just found a private tutor to come to the house

who

> should be starting soon.

>

> Oops - gotta go and do some work. I didn't realize it had gotten so

> late. Please write or call with any info re getting approval for

the

> growth hormone. It's not something I can afford to pay for out of

> pocket.

>

> Have an awesome Sunday.

>

>

>

[Guest guest]

Hi ,

I live in NH. I know very little about BCBS. I have not heard of

anyone being denied growth hormone from them. Did they give an

explanation?

Have you filed an appeal? Also, you might want to get your ped/endo

to write a letter to submit with your appeal explaning why Jillian

needs growth hormone. A letter from your pediatrician might help but

the ped/endo letter will carry more weight. You need to become a

little bit of a lawyer and private investigator.

I find it very odd that after 22 months they suddenly deny you GH. It

is important to find out why. What were the mitigating circumstances

that prompted this action?

In the meantime, if you need growth hormone, contact the growth

hormone supplier. Often they have a " bridge " program that will supply

growth hormone for a few months while you get this resolved.

Also, is there any chance you switch health insurance companies? We

used to have Harvard Pilgrim and never had a problem with them

regarding growth hormone.

Like with the school system or any other possible legal battle, get

everything in writing.

Sorry I can't be more help.

I hope this helps.

Ken M

>

> Hi Guys,

>

> Hope you are all doing OK. I have been away from the boards for a

> while because of school issues which has been consuming me for

> months. Just as I get that issue sorted out, I get informed that my

> new insurance company (Blue Cross Blue Shield of MA) have denied

> growth hormone coverage for Jillian. She has been on the drug for

22

> months and has done so well since starting it. Anyone out there

with

> BCBS of MA and a child with RSS get approved for coverage. If so,

how

> did you get approval?

>

> Jillie is doing great. She still needs a little oxygen and some GT

> feeds overnight but is otherwise forging ahead. She is walking

quite

> well now and has started walking up the stairs. She is eating 700

to

> 1000 cals a day by mouth and her variety of food is up (feeding

> therapy!!). Her favorite foods are spanakopita, hummus, tomatoes,

> pizza and dora cookies. She is picking up sign language quite well

so

> is less stressed with communication. Errol and I are taking weekly

> lessons and have just found a private tutor to come to the house

who

> should be starting soon.

>

> Oops - gotta go and do some work. I didn't realize it had gotten so

> late. Please write or call with any info re getting approval for

the

> growth hormone. It's not something I can afford to pay for out of

> pocket.

>

> Have an awesome Sunday.

>

>

>

[Guest guest]

HI MARCY AND VICTORIA,

My daughther has two coverages.The primary (dads) did not bother to

respond, however, mine APPROVED the GHT on the spot.

Due to the primary having a " pre-pay " clause, my coverage is always

used anyway, for instance, her Lupron. I am very happy about this.

Now I hope to help you..

My case was handled by a liaison between our selves and the

insurances. They prepare the case and then they approach the

insurance companies. Our case began on February 09, 2006. Approval

was yesterday due to no hassel. HERE IS THE NUMBER 1-,

AND YOU CAN CALL THEM AND ASK THEM TO HANDLE THIS FOR YOU or ask

what you must do to get them involved. The company is SPOC or Single

Point Of Contact (Reimbursement made simple). I hope you do not have

to take this on yourselves because they even try to get the GHT

while the fight is going on, if there is one; depending on the

chosen source. I have had a great experience with Nova Factor

providing Lupron so I was pleased to let them also handle the GHT.

Example: Our shipment got held up in customs between China and USA

and the Nova Factor sent out another Dose for my child. Lupron is

over $1200.00.

I hope this helps you and please let us know if your precious

children got the help.

Good Luck.

AvaMarie, Mother to ita

> Hi Guys,

>

> Hope you are all doing OK. I have been away from the boards for a

> while because of school issues which has been consuming me for

> months. Just as I get that issue sorted out, I get informed that

my

> new insurance company (Blue Cross Blue Shield of MA) have denied

> growth hormone coverage for Jillian. She has been on the drug for

22

> months and has done so well since starting it. Anyone out there

with

> BCBS of MA and a child with RSS get approved for coverage. If so,

how

> did you get approval?

>

> Jillie is doing great. She still needs a little oxygen and some GT

> feeds overnight but is otherwise forging ahead. She is walking

quite

> well now and has started walking up the stairs. She is eating 700

to

> 1000 cals a day by mouth and her variety of food is up (feeding

> therapy!!). Her favorite foods are spanakopita, hummus, tomatoes,

> pizza and dora cookies. She is picking up sign language quite well

so

> is less stressed with communication. Errol and I are taking weekly

> lessons and have just found a private tutor to come to the house

who

> should be starting soon.

>

> Oops - gotta go and do some work. I didn't realize it had gotten

so

> late. Please write or call with any info re getting approval for

the

> growth hormone. It's not something I can afford to pay for out of

> pocket.

>

> Have an awesome Sunday.

>

>

>

>

>

>

>

>

[Guest guest]

ADDIONAL info on SPOC. There is NO CHARGE for their service.

AvaMarie

-- In RSS-Support , " shanghavmri "

wrote:

>

> HI MARCY AND VICTORIA,

>

> My daughther has two coverages.The primary (dads) did not bother

to

> respond, however, mine APPROVED the GHT on the spot.

> Due to the primary having a " pre-pay " clause, my coverage is

always

> used anyway, for instance, her Lupron. I am very happy about this.

>

> Now I hope to help you..

>

> My case was handled by a liaison between our selves and the

> insurances. They prepare the case and then they approach the

> insurance companies. Our case began on February 09, 2006.

Approval

> was yesterday due to no hassel. HERE IS THE NUMBER 1-,

> AND YOU CAN CALL THEM AND ASK THEM TO HANDLE THIS FOR YOU or ask

> what you must do to get them involved. The company is SPOC or

Single

> Point Of Contact (Reimbursement made simple). I hope you do not

have

> to take this on yourselves because they even try to get the GHT

> while the fight is going on, if there is one; depending on the

> chosen source. I have had a great experience with Nova Factor

> providing Lupron so I was pleased to let them also handle the

GHT.

> Example: Our shipment got held up in customs between China and USA

> and the Nova Factor sent out another Dose for my child. Lupron is

> over $1200.00.

>

> I hope this helps you and please let us know if your precious

> children got the help.

>

> Good Luck.

>

> AvaMarie, Mother to ita

>

>

> > Hi Guys,

> >

> > Hope you are all doing OK. I have been away from the boards for

a

> > while because of school issues which has been consuming me for

> > months. Just as I get that issue sorted out, I get informed that

> my

> > new insurance company (Blue Cross Blue Shield of MA) have denied

> > growth hormone coverage for Jillian. She has been on the drug

for

> 22

> > months and has done so well since starting it. Anyone out there

> with

> > BCBS of MA and a child with RSS get approved for coverage. If

so,

> how

> > did you get approval?

> >

> > Jillie is doing great. She still needs a little oxygen and some

GT

> > feeds overnight but is otherwise forging ahead. She is walking

> quite

> > well now and has started walking up the stairs. She is eating

700

> to

> > 1000 cals a day by mouth and her variety of food is up (feeding

> > therapy!!). Her favorite foods are spanakopita, hummus,

tomatoes,

> > pizza and dora cookies. She is picking up sign language quite

well

> so

> > is less stressed with communication. Errol and I are taking

weekly

> > lessons and have just found a private tutor to come to the house

> who

> > should be starting soon.

> >

> > Oops - gotta go and do some work. I didn't realize it had gotten

> so

> > late. Please write or call with any info re getting approval for

> the

> > growth hormone. It's not something I can afford to pay for out

of

> > pocket.

> >

> > Have an awesome Sunday.

> >

> >

> >

> >

> >

> >

> >

> >