I want to apologize for wasting your time on this topic and
Hello all,
I want to apologize for wasting your time on this topic and on this valuable tool. We all have our insurance battles, and have little time for triviality, which this was. Replies were explaining how I should proceed. I knew that, I just vented in public and wasted your time. Apologies
Kevin C. Matthews, CO/LO
Advanced Orthopedic Designs
12315 Judson Rd. #206
San Antonio, Texas 78233
210-657-8100
210-657-8105 fax
www.AdvancedOrthopedicDesigns.com
Kevin@AdvancedOrthopedicDesigns.com
—– Forwarded Message —–
>From: Kevin Matthews
>To: OandP Listserv
>Sent: Thursday, June 27, 2013 8:10 PM
>Subject: Blue Cross out of state
>
>
>
>
>
>Hello all,
>
>
>Over the years I’ve been very frustrated with Blue Cross when it’s an out of state based group. Are you having these issues to?
>
>
>We routinely get denials from these plans, thankfully there are few that have these plans. Walmart is one. We have to fight them almost every time. Currently I am frustrated by a New Jersey plan. They denied SMOs for a child. They said they are considered foot orthoses and FOs not covered. We appealed saying the first word in the Medicare description is AFO,…Insurance is regulated by the state. Since they are out of state all our appeals and phone conversations need to be passed through a Texas plan rep. They have absolutely no authority, they simply pass on the message. We cannot speak or communicate directly with the plan administrators. This is chronic by the number of times it’s happened and the few claims there have been like this.
>
>
>
>My thinking is that businesses have no standing in other states so it is hard to prosecute complaints. We almost always get paid, but they put us through the course.
>
>
>
>Is this just us? I’ll post replies if any. Are SMOs considered FOs in New Jersey?
>
>Kevin C. Matthews, CO/LO
>Advanced Orthopedic Designs
>12315 Judson Rd. #206
>San Antonio, Texas 78233
>210-657-8100
>210-657-8105 fax
>www.AdvancedOrthopedicDesigns.com
>Kevin@AdvancedOrthopedicDesigns.com
>
>
