Guest guest Posted March 31, 2004 Report Share Posted March 31, 2004 Hi Hortensia, APPEAL APPEAL APPEAL!! In our files section, there is Insurance Help. Take a look at that. It has some appeals info in it. DOC also has an appeals package. I will look into that and email you the information directly. --- In Plagiocephaly , " hlbizubana " <hlbizub@h...> wrote: > HELLO PARENTS: > > I AM THE MOM OF TWINS, BOY AND GIRL. > MY GIRL WAS DIAGNOSED WITH PLAGIOCEPHALY. I REQUESTED THE APRROVAL > OF MY INSURANCE COMPANY AND THEY DENIED THE DOC BAND. > > CAN SOMEBODY GIVE ME SOME ORIENTATION ABOUT HOW TO APPEAL, AS WE ARE > CONCERNED ABOUT NOT HAVING OUR DAUGTHER USE THIS BAND TO CORRECT HER > PROBLEM. > > THANK YOU > > HORTENSIA BIZUB Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 31, 2004 Report Share Posted March 31, 2004 Hi Hortensia, Welcome to the group! If you are just getting started figuring out how to appeal your denial, you may want to visit the CappsKids website. They have a neat section where they sort how you should appeal based on the reason for the denial. Here is the link to their insurance help section: Capps Kids Insurance Help Section This section is devoted to helping parents with a Plagio child that have received a denial for Cranial Orthosis coverage by their insurance company. http://www.cappskids.org/PlagioInsuranceHelp.htm Also, we have a large amount of information you could read through (sample letters, appeals packets and such) here at the site. When you have time, please browse around the FILES section, INSURANCE folder, as well as the LINKS section, INSURANCE folder. Would you let us know if any of this information helps, and good luck with your appeal! Christie (Mom to Repo'd Remy) --- In Plagiocephaly , " hlbizubana " <hlbizub@h...> wrote: > HELLO PARENTS: > > I AM THE MOM OF TWINS, BOY AND GIRL. > MY GIRL WAS DIAGNOSED WITH PLAGIOCEPHALY. I REQUESTED THE APRROVAL > OF MY INSURANCE COMPANY AND THEY DENIED THE DOC BAND. > > CAN SOMEBODY GIVE ME SOME ORIENTATION ABOUT HOW TO APPEAL, AS WE ARE > CONCERNED ABOUT NOT HAVING OUR DAUGTHER USE THIS BAND TO CORRECT HER > PROBLEM. > > THANK YOU > > HORTENSIA BIZUB Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 1, 2004 Report Share Posted April 1, 2004 Hi, Your Cranial Tech office has all the information you need. Contact them and tell them your insuranc company denied you, they'll tell you what you need to do next. Good luck! --- In Plagiocephaly , " hlbizubana " <hlbizub@h...> wrote: > HELLO PARENTS: > > I AM THE MOM OF TWINS, BOY AND GIRL. > MY GIRL WAS DIAGNOSED WITH PLAGIOCEPHALY. I REQUESTED THE APRROVAL > OF MY INSURANCE COMPANY AND THEY DENIED THE DOC BAND. > > CAN SOMEBODY GIVE ME SOME ORIENTATION ABOUT HOW TO APPEAL, AS WE ARE > CONCERNED ABOUT NOT HAVING OUR DAUGTHER USE THIS BAND TO CORRECT HER > PROBLEM. > > THANK YOU > > HORTENSIA BIZUB Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 1, 2004 Report Share Posted April 1, 2004 Hortenisa, Welcome to the group. Be sure to get the appeal packet from Cranial Tech and good luck with your appeal! , mom to Hannah, DOC #3 3/30 Cape Cod, Ma --- In Plagiocephaly , " hlbizubana " <hlbizub@h...> wrote: > HELLO PARENTS: > > I AM THE MOM OF TWINS, BOY AND GIRL. > MY GIRL WAS DIAGNOSED WITH PLAGIOCEPHALY. I REQUESTED THE APRROVAL > OF MY INSURANCE COMPANY AND THEY DENIED THE DOC BAND. > > CAN SOMEBODY GIVE ME SOME ORIENTATION ABOUT HOW TO APPEAL, AS WE ARE > CONCERNED ABOUT NOT HAVING OUR DAUGTHER USE THIS BAND TO CORRECT HER > PROBLEM. > > THANK YOU > > HORTENSIA BIZUB Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 1, 2004 Report Share Posted April 1, 2004 No matter what you do...don't give up! They expect you to throw in the towel because it is a frustrating process and they are intimidating. We have Cigna and I mailed in my appeal the end of October. It didn't get paid until the end of February because it got overlooked. I was calling every couple of weeks for an update and was continuously misled. It is frustrating because, at least with Cigna, you never get to actually speak with the Appeal Dept, only customer service reps. I finally got a good one who pushed things ahead by getting her boss involved. I expected $2100 which was 70% after a $750 deductible. They paid 90% with no deductible. Maybe they paid that much because of my ordeal; but also I believe it was because I was a " pleasant thorn in their side " . Let them know you are not going away because often they turn down the first appeal just to discourage you. Find out if they have paid similar claims and although each case and insurance policy is different, it seems to help to throw that in. Good Luck! Swartout --- In Plagiocephaly , " hlbizubana " <hlbizub@h...> wrote: > HELLO PARENTS: > > I AM THE MOM OF TWINS, BOY AND GIRL. > MY GIRL WAS DIAGNOSED WITH PLAGIOCEPHALY. I REQUESTED THE APRROVAL > OF MY INSURANCE COMPANY AND THEY DENIED THE DOC BAND. > > CAN SOMEBODY GIVE ME SOME ORIENTATION ABOUT HOW TO APPEAL, AS WE ARE > CONCERNED ABOUT NOT HAVING OUR DAUGTHER USE THIS BAND TO CORRECT HER > PROBLEM. > > THANK YOU > > HORTENSIA BIZUB Quote Link to comment Share on other sites More sharing options...
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