Guest guest Posted February 6, 2010 Report Share Posted February 6, 2010 Our Daughter was diagnosed with Severe Brachycephaly from Cranial Tech. in Pasadena, California when she was 4.5 months. BCBS Ins denied coverage so we paid out of pocket and our Daughter is in her 7th week of the DOC Band with good results thus far. Our Ped doctor advised us to appeal the ins company so i did make a first appeal with help from this club. Today 2/6/10 just got a letter that initial denial is being " upheld " . The reason was that our daughter " was diagnosed with Brachycephaly and the use of an adjustable cranial orthosis is considered Investigational and not Medically necessary as a treatment of Brachycephaly " . " There is no documentation in the published peer reviewed medical literature which establishes the success of an adjustable cranial Orthosis as treatment of Brachycephaly " . Cranial tech said that our daughter did not have Plagiocephaly as her numbers were in Normal range but had severe Brachycephaly. Anyone have some advise? Our Doc said that we would not need a " Letter of medical Necessity " for the first appeal. Im planning on 2nd appeal but need some help.. thanks M Quote Link to comment Share on other sites More sharing options...
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