Blue Cross denied my ADHD treatment.?

[kane]

I was seeking "EEG biofeedback (neurofeedback)” treatment for my ADHD and was denied. Has anyone been successful in getting insurance to pay?

[eideard]

I'm a nurse and BCBS denies almost everything that the doctor feels is what the patient needs. It upsets me so much. Just recently, I had a patient who had failed one of three approved treatments for her condition. BCBS denied the other 2 treatments- even though we submitted clinical evidence and need for the treatments... the doctor wrote letters, we submitted her labwork, etc. After spending all day on the phone and being transferred 8 different times, I finally spoke to someone and asked them "if you are denying these treatments that the doctor feels are appropriate- just what are we supposed to treat her with?" I told her that I thought it was very wrong of them to deny a medication based soley on the cost and not on medical necessity. She stammered a bit, asked for my phone number, said, I will call you back. She called back within an hour, asked me what medication we initially wanted to put her on... I told her. She called me back and told me it was approved... Just make sure that you have a persistent doctor and a very persistent nurse working in your favor and you will get the treatment that you need! Sorry this is long but I wanted to let everyone know just how insurance company's work sometimes... I think it is very sad.

[shelly]

Sorry, Rover.

[simcha]

There is no good positive evidence that EEG Biofeedback works for ADHD. That is, there are very few, if any, studies. Insurance companies will only pay for treatments which have been verified to work. Most likely no matter what insurance company you have, you will have to pay out of pocket for EEG Biofeedback. You may want to try calling the insurance company yourself, as sometimes they are more responsive to their customers than the doctor.