GRRR

jimiv

New member
After doing all the research and hunting to find any and all resources to hlep pay for Parker's feeding tube supplements, I get a call from a "case manager" who says she is trying to help me get the resources I need. I explain my current dilemma and all her suggestions are to retrace my steps and call the same people again. She had not even heard of my grievance against BC/BS of LA for denying Parker's claim for the feeding materials. More to come if they have an origional thought.
 

jimiv

New member
After doing all the research and hunting to find any and all resources to hlep pay for Parker's feeding tube supplements, I get a call from a "case manager" who says she is trying to help me get the resources I need. I explain my current dilemma and all her suggestions are to retrace my steps and call the same people again. She had not even heard of my grievance against BC/BS of LA for denying Parker's claim for the feeding materials. More to come if they have an origional thought.
 

jimiv

New member
After doing all the research and hunting to find any and all resources to hlep pay for Parker's feeding tube supplements, I get a call from a "case manager" who says she is trying to help me get the resources I need. I explain my current dilemma and all her suggestions are to retrace my steps and call the same people again. She had not even heard of my grievance against BC/BS of LA for denying Parker's claim for the feeding materials. More to come if they have an origional thought.
 

jimiv

New member
After doing all the research and hunting to find any and all resources to hlep pay for Parker's feeding tube supplements, I get a call from a "case manager" who says she is trying to help me get the resources I need. I explain my current dilemma and all her suggestions are to retrace my steps and call the same people again. She had not even heard of my grievance against BC/BS of LA for denying Parker's claim for the feeding materials. More to come if they have an origional thought.
 

jimiv

New member
After doing all the research and hunting to find any and all resources to hlep pay for Parker's feeding tube supplements, I get a call from a "case manager" who says she is trying to help me get the resources I need. I explain my current dilemma and all her suggestions are to retrace my steps and call the same people again. She had not even heard of my grievance against BC/BS of LA for denying Parker's claim for the feeding materials. More to come if they have an origional thought.
 
B

Beaz

Guest
Hi Jim,
We were denied by BC/Personal Choice in PA too. They claimed it wasn't covered if it provided less than 75% of his daily calories. (some days it does!).
We appealed the decision, with testimony from the CF physician and the appeal was denied.
Now the strange part- they have been paying for it ever since????!!!!
The homecare that provides the supplies pre authorizes it every three months, it gets approved and they bill BC and BC pays. I have no idea why so I just keep my mouth shut and am grateful. It's like they just had to prove their point, then they were satisfied.
Maybe something like this could work for you!
What is the exact reason they won't cover it?
Fight the good fight and best of luck!
 
B

Beaz

Guest
Hi Jim,
We were denied by BC/Personal Choice in PA too. They claimed it wasn't covered if it provided less than 75% of his daily calories. (some days it does!).
We appealed the decision, with testimony from the CF physician and the appeal was denied.
Now the strange part- they have been paying for it ever since????!!!!
The homecare that provides the supplies pre authorizes it every three months, it gets approved and they bill BC and BC pays. I have no idea why so I just keep my mouth shut and am grateful. It's like they just had to prove their point, then they were satisfied.
Maybe something like this could work for you!
What is the exact reason they won't cover it?
Fight the good fight and best of luck!
 
B

Beaz

Guest
Hi Jim,
We were denied by BC/Personal Choice in PA too. They claimed it wasn't covered if it provided less than 75% of his daily calories. (some days it does!).
We appealed the decision, with testimony from the CF physician and the appeal was denied.
Now the strange part- they have been paying for it ever since????!!!!
The homecare that provides the supplies pre authorizes it every three months, it gets approved and they bill BC and BC pays. I have no idea why so I just keep my mouth shut and am grateful. It's like they just had to prove their point, then they were satisfied.
Maybe something like this could work for you!
What is the exact reason they won't cover it?
Fight the good fight and best of luck!
 
B

Beaz

Guest
Hi Jim,
We were denied by BC/Personal Choice in PA too. They claimed it wasn't covered if it provided less than 75% of his daily calories. (some days it does!).
We appealed the decision, with testimony from the CF physician and the appeal was denied.
Now the strange part- they have been paying for it ever since????!!!!
The homecare that provides the supplies pre authorizes it every three months, it gets approved and they bill BC and BC pays. I have no idea why so I just keep my mouth shut and am grateful. It's like they just had to prove their point, then they were satisfied.
Maybe something like this could work for you!
What is the exact reason they won't cover it?
Fight the good fight and best of luck!
 
B

Beaz

Guest
Hi Jim,
We were denied by BC/Personal Choice in PA too. They claimed it wasn't covered if it provided less than 75% of his daily calories. (some days it does!).
We appealed the decision, with testimony from the CF physician and the appeal was denied.
Now the strange part- they have been paying for it ever since????!!!!
The homecare that provides the supplies pre authorizes it every three months, it gets approved and they bill BC and BC pays. I have no idea why so I just keep my mouth shut and am grateful. It's like they just had to prove their point, then they were satisfied.
Maybe something like this could work for you!
What is the exact reason they won't cover it?
Fight the good fight and best of luck!
 
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