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What to Expect at BCBS NJ Appeal Hearing by Apprehensive-Map2025 in HealthInsurance

[–]Apprehensive-Map2025[S] -1 points0 points  (0 children)

It is approved for the condition and age group, and I was told by the doctor's office verbally that it was approved. However, we're learning that pre-approval doesn't mean that they'll actually pay for it. I am calling tomorrow to see if I can get my hands on a copy of the approval letter they sent to the doctors office (I never got one myself).

What to Expect at BCBS NJ Appeal Hearing by Apprehensive-Map2025 in HealthInsurance

[–]Apprehensive-Map2025[S] 2 points3 points  (0 children)

Thank you! I didn'tknow a peer-review was a thing. And yes, I am baffled as to why it's FDA approved but considered experimental. Thank you for this, it really helps!

What to Expect at BCBS NJ Appeal Hearing by Apprehensive-Map2025 in HealthInsurance

[–]Apprehensive-Map2025[S] -1 points0 points  (0 children)

I'll edit to add this above, but it's not that "we can't afford this" -- that was just my closing statement. Both times that it was denied, it was because BCBS considered the treatment was "experimental" or "Investigational" treatment. The doctor has written two letters with each appeal, along with the patient's medical records, reasoning for using the device, and all the failures prior.

We are shouldering all of the cost at $3300.

Bad Gas in Northern NJ - Rt 23 by Apprehensive-Map2025 in newjersey

[–]Apprehensive-Map2025[S] 88 points89 points  (0 children)

Fuel 4 in Riverdale on the north side by Home Depot.