[Parentsgroup-list] Fwd: Patient Advocate Comments And Suggestions

Justine Firnhaber-Baker firnhab at fas.harvard.edu
Mon Dec 4 14:43:37 EST 2006


It looks like well-baby visits are covered after all.  Wish me luck  
with the BCBS appeal.

best,
Justine


Begin forwarded message:

> From: "Cannon, Linda" <Lcannon at uhs.harvard.edu>
> Date: December 4, 2006 10:59:27 AM EST
> To: <firnhab at fas.harvard.edu>
> Subject: RE: Patient Advocate Comments And Suggestions
>
> Dear Justine,
>    Your pediatric benefit for BCBS outside in network providers is an
> age based benefit which is 6 well check ups during the first year of
> life, 3 visits during the second year and 1 visit per plan year from
> ages 2-5.  No benefits are provided for exams that are needed to take
> part in school, camp and sport activities; or by third parties.  The
> only exception to this is when these exams are furnished as part of a
> covered routine exam.
>    There is a 3 visit limit per year for sick visits.  I suggest you
> contact your Pediatricians office to see how they billed the visit. If
> it was a well visit and you haven't met your 6 I would then contact  
> BCBS
> at 1-800-257-8141 to inquire why it isn't being covered.
>    I'm not sure if the other parents feedback you are referring to  
> come
> to UHS for all of their Pediatric care which covers all sick and well
> visits.
>    If you have any additional questions or I can be of assistance  
> please
> let me know.
> Sincerely,
> Linda C. Cannon
> Patient Advocate
> 75 Mt. Auburn St.
> Cambridge, MA 02138
> Tel # 617-495-7583
> Fax# 617-496-6125
>
>
> -----Original Message-----
> From: webmaster at huhs.harvard.edu [mailto:webmaster at huhs.harvard.edu]
> Sent: Monday, December 04, 2006 10:33 AM
> To: Patient Advocate
> Subject: Patient Advocate Comments And Suggestions
>
> ********************************************************************** 
> **
> *******
> EmailAddress: firnhab at fas.harvard.edu
> Name:         Justine Firnhaber-Baker
> Submit:       Send
> Date:         Monday, 04 December 2006
>
> Comments:
>
> Hello.  I just received a BCBS statement for my 6-month old daughter's
> last well-baby visit. She uses an in-network pediatrician. The  
> statement
> said that they would not cover it because we are only allowed 3 office
> visits per year. Now, I know that they used to cover all well-baby
> visits, because I checked this out before I even got pregnant, and  
> I've
> heard from others that their childrens' well-baby visits were all
> covered.  Why are they refusing to cover this?  Thank you.
>
>
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