Re: United Healthcare denied us...

[Guest guest]

Sorry about the denial. I would definitely make sure that they are

considering the helmet under the right category. I've had that happen

with other things with my insurance. Hope you are successful in your

appeal!

Andi

Ryleigh 12/22/00

Connor 10/13/03

> Hello all - we just got our official denial of coverage letter for

> United Healthcare - we were expecting this, but I am REALLY pissed -

> the reason that they gave is that " orthotic services/appliances not

> covered. Your plan does not cover services and associated expenses

> for personal comfort items, including air conditioners and

> humidifiers, even if prescribed by a physician " PERSONAL COMFORT -

> yah, do they really think this is a personal comfort item. I was

> going to appeal before, but now I will stop at nothing to get them

> to pay! What an insult!! I was wondering if United Healthcare has

> paid for anyone else's helmet and if any of you have any advice. I

> will be following the appeals process they gave us, but any other

> help would be great. We do have coverage for durable medical goods

> and based on their definition her helmet should qualify. Thnkas for

> listening. - St. Louis

> Sydney (PPO helmet @ 9 mos.)

[Guest guest]

Hello

In our Database is a folder telling you which insurance paid for

what band / appeals and so on. United lists 12 as paid and 7as

denied. It also looks as if the ones paid for had 1 to 2 appeals on

average. Please don't give up.

Sandy Willow's mom

Torticollis resolved

Cranio Germany Grad 02/04

> Hello all - we just got our official denial of coverage letter for

> United Healthcare - we were expecting this, but I am REALLY

pissed -

> the reason that they gave is that " orthotic services/appliances

not

> covered. Your plan does not cover services and associated expenses

> for personal comfort items, including air conditioners and

> humidifiers, even if prescribed by a physician " PERSONAL

COMFORT -

> yah, do they really think this is a personal comfort item. I was

> going to appeal before, but now I will stop at nothing to get them

> to pay! What an insult!! I was wondering if United Healthcare

has

> paid for anyone else's helmet and if any of you have any advice.

I

> will be following the appeals process they gave us, but any other

> help would be great. We do have coverage for durable medical

goods

> and based on their definition her helmet should qualify. Thnkas

for

> listening. - St. Louis

> Sydney (PPO helmet @ 9 mos.)

[Guest guest]

Hey ,

What a crock reason for denial!

I see that you've already been directed to the Who's Insurance Paid

What database in the Database section of the group - that might give

you some encouragement. It's also good to hear that you do have DME

coverage, because it sure sounds like they didn't submit it under

the proper coding if you got that denial. I think the code should

be S1040.

Would you let us know how your appeal is coming along?

Take care,

Christie (Mom to Repo'd Remy)

> Hello all - we just got our official denial of coverage letter for

> United Healthcare - we were expecting this, but I am REALLY

pissed -

> the reason that they gave is that " orthotic services/appliances

not

> covered. Your plan does not cover services and associated expenses

> for personal comfort items, including air conditioners and

> humidifiers, even if prescribed by a physician " PERSONAL

COMFORT -

> yah, do they really think this is a personal comfort item. I was

> going to appeal before, but now I will stop at nothing to get them

> to pay! What an insult!! I was wondering if United Healthcare

has

> paid for anyone else's helmet and if any of you have any advice.

I

> will be following the appeals process they gave us, but any other

> help would be great. We do have coverage for durable medical

goods

> and based on their definition her helmet should qualify. Thnkas

for

> listening. - St. Louis

> Sydney (PPO helmet @ 9 mos.)

[Guest guest]

Hi -

We too have been denied after two appeals to United. We have DME

coverage but they are still pulling the same statement you got. We

are going to send everything to the benefits coordinator at my

husband's company and see if they can help. It is really annoying to

have worked so hard on this and be denied, and others have no

problem. Good luck to you.

(mom of lindsey Star band grad)

> > Hello all - we just got our official denial of coverage letter

for

> > United Healthcare - we were expecting this, but I am REALLY

> pissed -

> > the reason that they gave is that " orthotic services/appliances

> not

> > covered. Your plan does not cover services and associated

expenses

> > for personal comfort items, including air conditioners and

> > humidifiers, even if prescribed by a physician " PERSONAL

> COMFORT -

> > yah, do they really think this is a personal comfort item. I

was

> > going to appeal before, but now I will stop at nothing to get

them

> > to pay! What an insult!! I was wondering if United Healthcare

> has

> > paid for anyone else's helmet and if any of you have any

advice.

> I

> > will be following the appeals process they gave us, but any

other

> > help would be great. We do have coverage for durable medical

> goods

> > and based on their definition her helmet should qualify. Thnkas

> for

> > listening. - St. Louis

> > Sydney (PPO helmet @ 9 mos.)