Guest guest Posted July 22, 2003 Report Share Posted July 22, 2003 Hi! Wondering if anyone would have any suggestions on how to appeal an insurance denial? After waiting several months to find out whether we were approved or not we went ahead and got our daughter in the Starband. We have now been denied by UHC. There is a specific clause in our policy excluding Cranial Bands. Now our HR Representative wants us to still appeal but I am at a loss on what information I should send. If any one has any suggestions I would greatly appreciate it. Thanks, Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 18, 2004 Report Share Posted June 18, 2004 hi paula, i have heard other people also say that they put in their appeals letter the fact that other insurance carriers are paying for the bands. there is a post on the cranial tech site that is about winning an appeal for bcbs in texas. kelly(mom to kathryn,plagio,brachy,tort,banded 5/03,texas) --- In Plagiocephaly , " a " <dpharris@h...> wrote: > We were recently denied coverage by Blue Cross Blue Shield. They feel the DOC band is " experimental and investigational. " I read the appeal letters posted on the website (thanks to everyone who posted this info, it's been EXTREMELY helpful) and it appears the fact the band is FDA approved is the primary basis to use for an appeal. If anyone else was denied for this reason, were you able to gather other evidence to show the band is not experimental or investigational? I'm trying to gather as much ammunition as I can for our appeal. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 18, 2004 Report Share Posted June 18, 2004 Do you have the appeal packet from Cranial Tech? It's extremely helpful and is broken down by reason of denial. , mom to Hannah, DOCband #3 3/30 Cape Cod, Ma --- In Plagiocephaly , " a " <dpharris@h...> wrote: > We were recently denied coverage by Blue Cross Blue Shield. They feel the DOC band is " experimental and investigational. " I read the appeal letters posted on the website (thanks to everyone who posted this info, it's been EXTREMELY helpful) and it appears the fact the band is FDA approved is the primary basis to use for an appeal. If anyone else was denied for this reason, were you able to gather other evidence to show the band is not experimental or investigational? I'm trying to gather as much ammunition as I can for our appeal. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 18, 2004 Report Share Posted June 18, 2004 Thank you. I will check it out. Re: Insurance Denial hi paula, i have heard other people also say that they put in their appeals letter the fact that other insurance carriers are paying for the bands. there is a post on the cranial tech site that is about winning an appeal for bcbs in texas.kelly(mom to kathryn,plagio,brachy,tort,banded 5/03,texas)> We were recently denied coverage by Blue Cross Blue Shield. They feel the DOC band is "experimental and investigational." I read the appeal letters posted on the website (thanks to everyone who posted this info, it's been EXTREMELY helpful) and it appears the fact the band is FDA approved is the primary basis to use for an appeal. If anyone else was denied for this reason, were you able to gather other evidence to show the band is not experimental or investigational? I'm trying to gather as much ammunition as I can for our appeal.For more plagio info Quote Link to comment Share on other sites More sharing options...
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