This past Monday, I filed an appeal with Blue Cross and Blue Shield. My argument was that we be reimbursed the 32 days that our daughter was in the Atlanta facility. While in Atlanta, our daughter did not received adequate therapy due to the facility being short staffed. We were told at one point, by our daughter's therapist that she was covering two units of girls, each of which housed 20 girls.
My wife and I feel that due to the lack of staff at the Atlanta facility, our daughter was set back in her treatment. Also, BCBS only allowed her to stay at the Atlanta facility for 28 days before cutting off her coverage and said it wasn't necessary. Since our BCBS policy only allows 60 days of residential treatment coverage per person, per year, we have 32 days left. The clock started on June 23 and after 32 days, we will be responsible for the daily cost of $1000 per day. This is why I was determined to file my appeal as soon as possible.
Today I received a call from BCBS. They advised me that they reviewed my appeal, but decided to deny it and that there was nothing further I could do. This was like a punch in the stomach. I thought they would at least provide me some other options, but I guess the bottom line is there top priority.
I will continue to make calls and send emails to BCBS in hopes of annoying the right person. Meanwhile, my wife has been speaking with the state insurance that our children have due to them being adopted. The hurdle there is that the facility is in Tennessee and Florida state insurance doesn't cross state lines. There is a slim chance that they can make a case by case exception and help us. We will continue to pray that they help us.