United HealthCare in Texas pd for HBOT

[Guest guest]

Group I wanted to share this info about United Healthcare paying for HBOT. I

read this on medicaidforhbot website. Cyndi B United Health Care pays for HBOT

in Texas. We had a paitnet that filed for

services for HBOT and United agreed to pay. Upon the 25 treatment they had an

auditor overlook the claim and recalled the claim.

However we filed a claim or we should say and apeal and fought on the grounds of

Detrimental Reliance of Services. Basically we stated by aproving the treatment

and then recanting would put the family in detriment. They would not be able to

pay the claim leaving them broke.

They ended up paying for the full 40 and said they would review the case upon

the completion of the 40 before they would pay for any more. Allthough this case

was not one on medical basis it was still won.

We had a simular cituation in 2002 that gave us the idea with Blue Cross Blue

Sheild and they paid. The interesting thing about Blue Cross was after the first

40 upon reviewing the documentation they paid for another 40 and then stopped.

However they only paid for one Spec Scan they would not pay for the follow up

scan. The parents had to pay that claim but did so and was awarded the second

set of 40.