Re: Aetna U.S. Healthcare Managed Choice

[Guest guest]

and , we also have Aetna (PPO) and have yet to hear whether or not

they will cover the helmets for our sons (it has been over a month since they

got their helmets). I will make sure to keep you both posted since it seems we

are fighting the same enemy. (;

>>> <fozzie@...> 06/20/00 07:26PM >>>

Hi ,

I have Aetna U.S. Health Care also with the PPO option. I just

received a notice that they are requesting more info from the clinic

regarding treatment. I will let you know how it goes,

>

> Some information I found out today. We have United Healthcare

EPO.

> Last Nov when we got the referral from our ped for the

craniofacial

> specialist, we were warned that United Healthcare historically

did

> not, would not, had not, paid for the DOC band. We decided

that no

> matter what, our son needed the band, so we went on the payment

plan

> with Cranial Tech and got the process started in February (in

Nov the

> first avail for craniofacial specialist was Jan 25th - uggh, so

> didn't see Cranial Tech til first week of Feb - hated waiting

and

> losing time). We hoped and prayed maybe, maybe they'd pay, but

if

> not, we'd figure out some way to make it happen on our side.

Well,

> along came April, and an appeal later, we got a wonderful

letter in

> the mail saying that United Healthcare would pay all but the

$200

> copay! How's that for an answer to prayer?

> At his exit appt today with the craniofacial specialist, we

> discussed the insurance paying, and she said that starting in

April

> 2000, United Healthcare switched their position on the bands,

and

> started paying.

> Hopefully this will be good news to somebody!

> p.s.

> 's head reshaped beautifully - we are extremely pleased -

it

> takes a careful study to see a couple areas that didn't get all

the

> way reshaped before he outgrew the band.

> p.p.s.

> As part of the appeal process, we got my husband's company's

human

> resource dept involved - turned out they had two other families

going

> thru same process - there was strength in numbers I believe,

and

> strength in coming from the HR insurance dept. Can't hurt to

get

> anyone involved that will plead your case for you.

>

>

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