Insurance companies are odd animals, with policy decisions that are unpredictable. Many folks here have been denied coverage from BCBS, while others have won coverage.

This link may have been posted before, but I just wanted to remind folks that have started their frustrating journey of appealing to read this 18 page document. It summarizes BCBS's official stance on ADR:

http://www.bcbs.com/tec/vol20/20_01.html

It's dated April 2005, so there may be some minor changes since then. All the while, some people have been successful getting coverage -- as we have seen considerable differences from state to state. Apparently, each regional (or state) organization has some latitude to make their own policy decisions. Great from some people -- but not for others. Makes you wonder about moving in with your cousins in another state?!

Any way, read the doc carefully if you plan to take them head on, and feel free to network among members here.

PS: You need a PDF reader to open the document.

BCBS is weird. They ok'd a two-level but in their small print authorization, they said that the procedure could be held for medical review. In essence, I would have wandered into surgery really not knowing if they'd pay (and the doc nor hospital could say for sure). Best, Allan

Your health insurance is really quite odd, I can't understand why, you have coverage for a procedure in one state and not another by the same insurance co.
I can understand discrepancies between different insurance companies, but different states http://adrsupport.org/groupee_common...s/icon_eek.gif In Australia, you're covered in all states. The premium may vary from state to state but not what's covered.
I guess there's an advantage living upside down to the rest of the world http://adrsupport.org/groupee_common...on_biggrin.gif
Hucky

The American Insurance industry is a joke.

It is time the federal government regulates it and forces a conformity for all states.

Americans are at the mercy of each company as they are incorporated in each state. They can change their policies using the rules (or lack there of) in each states Insurance Commission.

It is time that the US Goverment requires all insurance companies to have the same policies for every state they are incorporated in....

IMHO... John

Posted for Brenda:

BRENDAWY
Junior Member
Member # 423

July 05, 2005 09:24 AM

I HAVE BEEN RESEARCHING BACK INTO THE TECH ASSESSMENT PAGES. SO FAR I HAVE GONE BACK 5 MONTHS. I HAVE NOT FOUND ONE ITEM THAT HAS MET THEIR TECH CRITERIA. I PLAN ON LOOKING BACK ONE YEAR. I FIND IT INTERESTING THAT THIS COMPANY WORKS FOR BC/BS AND SEEMS TO BE BIASED. I WOUNDER IF I END UP WITH A LAWYER HOW THAT WILL LOOK IN C
COURT? JUST A THOUGHT. BRENDAWY
P.S. I DID NOT SEE A NUERO OR ORTHOPEDIC DR ON THEIR BOARD