Guest guest Posted March 29, 2004 Report Share Posted March 29, 2004 ugh... sorry this is a little late... Tavin got his helmet on Thursday 3/25. We are blessed with such a trooper!! He has been through so much in his little life. He didn't balk one bit when the helmet was placed on his head. He only seems to care when you are putting on and taking it off. So we have learned how to do it quickly!! He is now wearing it 6-8 hours at a time with no problems. Tomorrow or the next day he will be in it around the clock. So that was the good part.... now for the rest of the story............ We got this helmet or 'cranial orthotic' (FYI: better wording for insurance purposes) from Hanger Orthotics here in Louisville. BUT, our insurance company-the wonderful United Health Care had not approved it YET. Last minute, Hanger informs us that we have to pay $400 up front in order to use the helmet. We were told initially by Hanger that they would exhaust all efforts with the insurance company before we had to pay?? Then they tell us in the office when we are there to pick it up that we have to pay for it??? That was a bit annoying. Anywho.... the insurance company. We did (well Elliott did) a lot of homework prior to all our appointments with COPC, Hanger, Chariker, etc. We were told by UHC that you DO NOT need prior approval for a cranial orthotic and that it was covered!! Hooray.... what a victory and it was so easy................. HA!!! Well our bubble was popped just days prior to picking up the cranial orthotic, when Elliott called UHC just to make sure we would have no surprises!! Ugh, what a surprise to find out that the cranial orthotic request was 'under investigation'. We were previously told the INCORRECT info by the girl at UHC. Their excuse: she was new, didn't know. So, after MANY calls to UHC we have heard various stories. Who knows which one is right, if any, at this point. We are very frustrated, but feel the squeaky wheel will get the oil. So, Elliott calls UHC EVERYDAY!! A " rush " has been put on the 'investigation', whatever that means. The orthotist at Hanger feels pretty confident that it will be denied but feels that after a few appeals they should pay!!!!! Ugh.... so that is our update.... Janet & Tavin (7 mo in a Hanger cranial orthotic) Louisville, KY Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 29, 2004 Report Share Posted March 29, 2004 Hi Janet, I'm so glad Tavin is adjusting so well to his helmet. That is certainly a relief, huh? As far as your problems w/UHC, I think they should stand by what they told you in the first place. We also made daily phone calls to our BCBS and wrote down who we talked to, etc. All the hard work paid off for us, and I hope it does for you too! , mom to Hannah, DOC #3 3/30 Cape Cod, Ma > ugh... sorry this is a little late... > > Tavin got his helmet on Thursday 3/25. We are blessed with such a trooper!! > He has been through so much in his little life. He didn't balk one bit when > the helmet was placed on his head. He only seems to care when you are > putting on and taking it off. So we have learned how to do it quickly!! He > is now wearing it 6-8 hours at a time with no problems. Tomorrow or the > next day he will be in it around the clock. > > So that was the good part.... > now for the rest of the story............ > > We got this helmet or 'cranial orthotic' (FYI: better wording for insurance > purposes) from Hanger Orthotics here in Louisville. BUT, our insurance > company-the wonderful United Health Care had not approved it YET. Last > minute, Hanger informs us that we have to pay $400 up front in order to use > the helmet. We were told initially by Hanger that they would exhaust all > efforts with the insurance company before we had to pay?? Then they tell us > in the office when we are there to pick it up that we have to pay for it??? > That was a bit annoying. > > Anywho.... the insurance company. We did (well Elliott did) a lot of > homework prior to all our appointments with COPC, Hanger, Chariker, etc. We > were told by UHC that you DO NOT need prior approval for a cranial orthotic > and that it was covered!! Hooray.... what a victory and it was so > easy................. HA!!! > > Well our bubble was popped just days prior to picking up the cranial > orthotic, when Elliott called UHC just to make sure we would have no > surprises!! Ugh, what a surprise to find out that the cranial orthotic > request was 'under investigation'. We were previously told the INCORRECT > info by the girl at UHC. Their excuse: she was new, didn't know. So, after > MANY calls to UHC we have heard various stories. Who knows which one is > right, if any, at this point. We are very frustrated, but feel the squeaky > wheel will get the oil. So, Elliott calls UHC EVERYDAY!! A " rush " has been > put on the 'investigation', whatever that means. The orthotist at Hanger > feels pretty confident that it will be denied but feels that after a few > appeals they should pay!!!!! > > Ugh.... so that is our update.... > > Janet & Tavin (7 mo in a Hanger cranial orthotic) > Louisville, KY Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 30, 2004 Report Share Posted March 30, 2004 Hi Janet: Glad Tavin (love the name!) is doing so well thus far. He's on the road to a rounder head as we speak. As for ins., ugh, keep pestering away with them for coverage, very frustrating & tedious, but often pays off! Keep us posted. Debbie > > > ugh... sorry this is a little late... > > > > Tavin got his helmet on Thursday 3/25. We are blessed with such a > trooper!! > > He has been through so much in his little life. He didn't balk > one bit when > > the helmet was placed on his head. He only seems to care when you > are > > putting on and taking it off. So we have learned how to do it > quickly!! He > > is now wearing it 6-8 hours at a time with no problems. Tomorrow > or the > > next day he will be in it around the clock. > > > > So that was the good part.... > > now for the rest of the story............ > > > > We got this helmet or 'cranial orthotic' (FYI: better wording for > insurance > > purposes) from Hanger Orthotics here in Louisville. BUT, our > insurance > > company-the wonderful United Health Care had not approved it YET. > Last > > minute, Hanger informs us that we have to pay $400 up front in > order to use > > the helmet. We were told initially by Hanger that they would > exhaust all > > efforts with the insurance company before we had to pay?? Then > they tell us > > in the office when we are there to pick it up that we have to pay > for it??? > > That was a bit annoying. > > > > Anywho.... the insurance company. We did (well Elliott did) a lot > of > > homework prior to all our appointments with COPC, Hanger, > Chariker, etc. We > > were told by UHC that you DO NOT need prior approval for a cranial > orthotic > > and that it was covered!! Hooray.... what a victory and it was so > > easy................. HA!!! > > > > Well our bubble was popped just days prior to picking up the > cranial > > orthotic, when Elliott called UHC just to make sure we would have > no > > surprises!! Ugh, what a surprise to find out that the cranial > orthotic > > request was 'under investigation'. We were previously told the > INCORRECT > > info by the girl at UHC. Their excuse: she was new, didn't know. > So, after > > MANY calls to UHC we have heard various stories. Who knows which > one is > > right, if any, at this point. We are very frustrated, but feel > the squeaky > > wheel will get the oil. So, Elliott calls UHC EVERYDAY!! > A " rush " has been > > put on the 'investigation', whatever that means. The orthotist at > Hanger > > feels pretty confident that it will be denied but feels that after > a few > > appeals they should pay!!!!! > > > > Ugh.... so that is our update.... > > > > Janet & Tavin (7 mo in a Hanger cranial orthotic) > > Louisville, KY Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 30, 2004 Report Share Posted March 30, 2004 Janet, glad to hear that Tavin is tolerating his band. Great news!! On the other hand, sorry to hear about UHC. In my time with the group I have heard so many different things about UHC. Good luck with them, tell Elliot not to give up on them!! You know the old saying, " the squeeky wheel gets greased! " . Keep us posted. Dustie > ugh... sorry this is a little late... > > Tavin got his helmet on Thursday 3/25. We are blessed with such a trooper!! > He has been through so much in his little life. He didn't balk one bit when > the helmet was placed on his head. He only seems to care when you are > putting on and taking it off. So we have learned how to do it quickly!! He > is now wearing it 6-8 hours at a time with no problems. Tomorrow or the > next day he will be in it around the clock. > > So that was the good part.... > now for the rest of the story............ > > We got this helmet or 'cranial orthotic' (FYI: better wording for insurance > purposes) from Hanger Orthotics here in Louisville. BUT, our insurance > company-the wonderful United Health Care had not approved it YET. Last > minute, Hanger informs us that we have to pay $400 up front in order to use > the helmet. We were told initially by Hanger that they would exhaust all > efforts with the insurance company before we had to pay?? Then they tell us > in the office when we are there to pick it up that we have to pay for it??? > That was a bit annoying. > > Anywho.... the insurance company. We did (well Elliott did) a lot of > homework prior to all our appointments with COPC, Hanger, Chariker, etc. We > were told by UHC that you DO NOT need prior approval for a cranial orthotic > and that it was covered!! Hooray.... what a victory and it was so > easy................. HA!!! > > Well our bubble was popped just days prior to picking up the cranial > orthotic, when Elliott called UHC just to make sure we would have no > surprises!! Ugh, what a surprise to find out that the cranial orthotic > request was 'under investigation'. We were previously told the INCORRECT > info by the girl at UHC. Their excuse: she was new, didn't know. So, after > MANY calls to UHC we have heard various stories. Who knows which one is > right, if any, at this point. We are very frustrated, but feel the squeaky > wheel will get the oil. So, Elliott calls UHC EVERYDAY!! A " rush " has been > put on the 'investigation', whatever that means. The orthotist at Hanger > feels pretty confident that it will be denied but feels that after a few > appeals they should pay!!!!! > > Ugh.... so that is our update.... > > Janet & Tavin (7 mo in a Hanger cranial orthotic) > Louisville, KY Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.