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Posted by Carole Perdon on March 16, 2004 at 10:57:07:

My son was involved in a hit-and-run accident on 2/25/03. He suffered traumatic brain injury and extensive facial injuries. He is blind in left eye, limited range of motion right arm, limited use of right hand. His face was like confetti - completely broken. I have sent pictures, letters, telephone messages, etc., but Oxford will not pay for the reconstructive surgery that my son had a short time after the accident, surgery that rebuilt his face!! I have heard, wrong CPT codes by doctor, not submitted on time, not covered, elective surgery, or worse yet, no response at all to inquiries. My son still needs surgery, but who will perform it when they can't even get paid for the surgery necessary to fix him, knowing that they surely will not get paid for "plastic surgery" for scars - I mean, for God's sake, his nose was missing, his eye was down by his cheek, his left eye socket was crushed, his optic nerve crushed. What does it take to get this surgery paid for and future ones approved? I am ready to file a Bad Faith law suit.


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