oh Blue Cross, how I hate you!

I think I use more of my cell minutes on the phone with Blue Cross than I do with my friends, and I’m over it. I’m angry. It’s ridiculous.

I have had issues with them in the past regarding Henry’s coverage for therapy. I have made appeals and thankfully won. I was gearing up as we approached the cap of our 45 visits per year that were allotted, and assumed that was the next battle on my hands. I was preparing.

I was not expecting full denial of coverage for him based on the fact that he is now attending preschool. I have heard of this happening, foolishly I didn’t think it would happen to us. I had already fully explained the necessity of one on one intense and consistent private therapy for Henry…and I seemed to convince them. Now their view is that the school should be responsible for all of his therapy moving forward. We have a lovely and well respected speech therapist at his school, but he has a great connection with our private SLP and has made such progress with her and I don’t want to lose momentum. Why would we change something that is working? Why is it so hard to get our kids what they need? It makes me nuts.

I contacted BCBS again to go through the details of the appeal process and then I contacted CASANA for some guidance in drafting a letter. They were kind enough to share a sample appeal for a similar situation and I modified it for our case specifically. I got amazing letters from our SLP and neurologist  to support the appeal and I included the cutest picture of Henry I could find. Now we are waiting fingers crossed.

ps. I have another letter to BCBS stating how I really feel, holding nothing back. It was never sent of course, it’s something that is drafted only in my head and replayed every time I have to deal with their idiocy. I thought I would share it here, but then thought the foul language might offend :)

Advertisements

3 thoughts on “oh Blue Cross, how I hate you!

  1. I hate them too. We have yet to be reimbursed for a single therapy session Camden has had so far this year. I am constantly calling them to nag them about it and still, nothing has come of it. It’s so frustrating. I don’t understand why they make this process so difficult for parents who just want to help their kids.

    • It’s too bad that I’m not the only ones with these insurance battles. To me it’s one of the main things wrong with this country…I’m just experiencing it all first hand now.

  2. Oh do I COMPLETELY understand how frustrating BCBS can be. I do feel that it’s
    Not limited to just them however they have been quite challenging. I finally figured out the coding we needed to get appropriate coverage for our therapy and then bombshell the therapy office had dropped the ball and never changed her dx code and we were facing $98 speech therapy visits 3x week. Hahahaha yea right. Who can legit afford that? $270 week??? Sure. Got that covered 52 weeks a year. Insurance holds a very close hate/love relationship in my heart. I get this. And I wish you the best with your journey!

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

w

Connecting to %s