Guest guest Posted August 17, 2000 Report Share Posted August 17, 2000 Unless your insurance company keeps notes in the computers about who called and when...for example... mother states child's loss was genetic. Also if you have all those genetic tests, which the insurance has paid for, which say the deafness is or is not genetic. If you are going to be less than truthful it could come back to bite you in the butt. My insurance company knows when I called and who I talked to regarding claims, every time. >From: LSVG@... >Reply-To: Listen-Upegroups >To: Listen-Upegroups >Subject: Re: Digest Number 635 >Date: Thu, 17 Aug 2000 22:08:09 EDT > >In a message dated 8/17/00 2:42:52 PM Eastern Daylight Time, >Listen-Upegroups writes: > ><< Here's the lawyer side of me sneaking out -- unless you have a confirmed >genetic blood test of the presence of a gene that is aboslutely >inextricably >linked with hearing loss, you can say that you don't know the source >without >lying. > > Sheri >> > >Oooo la la! I do love this thought! GO WITH IT DIANE! Don't give up! If >all else fails, then maybe the media needs to hear about all these denial >cases. > ________________________________________________________________________ Get Your Private, Free E-mail from MSN Hotmail at http://www.hotmail.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 17, 2000 Report Share Posted August 17, 2000 In a message dated 8/17/00 2:42:52 PM Eastern Daylight Time, Listen-Upegroups writes: << I called back United Healthcare and they now tell me that they don't cover speech for genetic hearing loss. They said that I can challenge the decision. >> Diane, One of the best weapons is to have your daughter's ENT write a letter stating that the child needs INTENSIVE therapy in order for her to maximize the potential her aids give her etc. etc. Have your SLP write a letter stating PROGRESS that your daughter's been making and that by stopping therapy or cutting down sessions, she will NOT continue to make this progress. I say this because if there is progress, then it's working and they can't deny it. If possible, have the audiologist send a letter stating the gains she has with her aids and that speech production will happen with INTENSIVE. I too went through this many years ago with my son. First it was a covered expense. Then all of a sudden they told me that I shouldn't of been having the therapy to begin with! I fought it with letters and all and they did extend some therapy. KEEP FIGHTING! They are hoping you get tired of it. It's so frustrating isn't it? It is time for us to write our politicians and tell them that insurance companies are hurting our children by limiting coverage in this area. GOOD LUCK! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 17, 2000 Report Share Posted August 17, 2000 In a message dated 8/17/00 2:42:52 PM Eastern Daylight Time, Listen-Upegroups writes: << Here's the lawyer side of me sneaking out -- unless you have a confirmed genetic blood test of the presence of a gene that is aboslutely inextricably linked with hearing loss, you can say that you don't know the source without lying. Sheri >> Oooo la la! I do love this thought! GO WITH IT DIANE! Don't give up! If all else fails, then maybe the media needs to hear about all these denial cases. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 18, 2000 Report Share Posted August 18, 2000 I never really told them that her loss was genetic. The words I used this week were binaural sensorneural hearing loss. The guy who answered the phone had to ask a nurse what that meant. I doubt that he took notes. By the way, my husband called yesterday and they agreed to twenty sessions a year. I told him he has to keep going so that we get 50 a year. If the insurance co pays for 50 and the school district provides for one hour a week and we get back up for saturdays, then we should be ok. Its just that at 100 per hour, we can't pay for 2 sessions a week. I'll keep you posted on how the insurance shapes up. diane Re: Digest Number 635 >Date: Thu, 17 Aug 2000 22:08:09 EDT > >In a message dated 8/17/00 2:42:52 PM Eastern Daylight Time, >Listen-Upegroups writes: > ><< Here's the lawyer side of me sneaking out -- unless you have a confirmed >genetic blood test of the presence of a gene that is aboslutely >inextricably >linked with hearing loss, you can say that you don't know the source >without >lying. > > Sheri >> > >Oooo la la! I do love this thought! GO WITH IT DIANE! Don't give up! If >all else fails, then maybe the media needs to hear about all these denial >cases. > ________________________________________________________________________ Get Your Private, Free E-mail from MSN Hotmail at http://www.hotmail.com All messages posted to this list are private and confidential. Each post is the intellectual property of the author and therefore subject to copyright restrictions. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 18, 2000 Report Share Posted August 18, 2000 In a message dated 8/18/00 11:37:58 AM Eastern Daylight Time, DGIORDANO@... writes: > No, thats my point. I didn't go into connexin 26. I thought I'd save that. > No one knows what it is anyway. I've mentioned it to doctors and have > gotten blank stares. > They may not know, but they can ask! Was the testing done thru your insurance? It may well be listed as genetic testing! I would drag out the paperwork you got for the testing and see if it lists it anywhere on it. A hearing loss due to Connexin 26 IS genetic! Orla Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 18, 2000 Report Share Posted August 18, 2000 That doesnt mean it is genetic...does it? Betty > I never really told them that her loss was genetic. The words I used this > week were binaural sensorneural hearing loss. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 18, 2000 Report Share Posted August 18, 2000 No, thats my point. I didn't go into connexin 26. I thought I'd save that. No one knows what it is anyway. I've mentioned it to doctors and have gotten blank stares. Re: Digest Number 635 That doesnt mean it is genetic...does it? Betty > I never really told them that her loss was genetic. The words I used this > week were binaural sensorneural hearing loss. All messages posted to this list are private and confidential. Each post is the intellectual property of the author and therefore subject to copyright restrictions. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 18, 2000 Report Share Posted August 18, 2000 > By the way, my husband called yesterday and they agreed to twenty sessions a > year. I told him he has to keep going so that we get 50 a year. Do you happen to be in Colorado? Recent changes in the law there now only require insurance companies to pay for 20 visits a year (like they think less than 1/2 hour a week is going to make a difference? Good luck on the battle! Kay Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 18, 2000 Report Share Posted August 18, 2000 we are in NY. I'm trying to find the state insurance law on this issue. Re: Digest Number 635 > By the way, my husband called yesterday and they agreed to twenty sessions a > year. I told him he has to keep going so that we get 50 a year. Do you happen to be in Colorado? Recent changes in the law there now only require insurance companies to pay for 20 visits a year (like they think less than 1/2 hour a week is going to make a difference? Good luck on the battle! Kay All messages posted to this list are private and confidential. Each post is the intellectual property of the author and therefore subject to copyright restrictions. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 18, 2000 Report Share Posted August 18, 2000 > If you are going to be less than > truthful it could come back to bite you in the butt. I agree with you . Be aware, everybody, that if your insurance company decides down the road that they paid something in error (whether it was your fault or not), you have to pay the money back to the insurance company. If they determine that you intentionally misled them, then they could terminate all your benefits. Once again, if it were me, I would for a copy in writing of clarification of the determination including how they determined the loss was genetic. My thinking on this is actually that when he asked someone, they probably said generic and the guy re-stated it as genetic. At any rate, either way, it smacks of discrimination and a if you indeed get their policy in writing, a complaint to your states agency that oversees insurance companies might be in order. Hugs, Kay Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 18, 2000 Report Share Posted August 18, 2000 At 11:05 AM 8/18/00 -0400, you wrote: >No, thats my point. I didn't go into connexin 26. I thought I'd save that. >No one knows what it is anyway. I've mentioned it to doctors and have >gotten blank stares. If you had the test, though, isn't there a record of it with your ENT? Your insurance company can get access to those records if they want to. --kerri Quote Link to comment Share on other sites More sharing options...
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