FIGHTING! MORE DOCUMENTS?

Hello All, Well here I go again. I just received a letter from BCBS stating my benefit  elig. cannot be determined  because they want chart notes documenting the asthma and sleep apnea that is not controlled even with the use of conventional therapy. What does that mean? I get the feeling they are trying any thing to denie me? I have been on a cpap for a short time for sleep apnea. Now what? Thanks for listening

Hi, For me, I had to have documented that the CPAP was not controlling my sleep apnea.  From the time I found out I had sleep apnea (last July), it took me until April of this year to get my approval.  I assumed that just because I was diagnosed with sleep apnea, I was covered.  That was not the case for BCBS with me.   I had struggled with the CPAP since I got it.  I still had symptoms of uncontrolled sleep apnea, so a visit to the sleep doctor and a letter documenting my CPAP was not controlling my sleep apnea is what it took for my insurance to cover. Basically, after my initial denial and appeal and subsequent denial, I let it sit for a while.  I didn't start pursuing again until March.  What I found then when I read between the lines of my denial letter was that any qualifying comorbidity didn't count if it were controlled by medication or CPAP. Good Luck.