Guest guest Posted November 22, 2004 Report Share Posted November 22, 2004 yeah!!! we won our appeal from the EVIL UHC. just to remind you of who we are, jacob & isaac 17mos(servere plagio & tort)we have been in pt since march for tort, jacob was previously approved for a DOC in April, and graduated sept 1. he needs another. Isaac was never approved!!(same diagnosis & severity as jacob) we have been fighting UHC for Isaac since April. 's 2nd rx was also denied(again for cosmetic). we got the biggest run around, they actually told us they never approved jacob's first DOC. even though it was already paid for by them. we got alot of A told B but not C, who doesnt talk to directly to B. get it! CONFUSING!! When we appealed jacob's first DOC our nuero did a Peer to Peer with the UHC dr who was dening our claim. when we tried to do that for his second they wouldnt let us, said they dont do that. EVIL!! well when i got that call from our dr, i called my hubby crying, and upset, we have been going through this for months and the boys are getting so big. so it was hubby to the rescue. lol. he called his hr person at work, and our lawyer, and had a conference call with UHC director of complaint dept. he told them of our run around(trust me this is the short version) and time situation with the boys getting so old. We faxed our appeal directly to him the next day. he said it would be to the review board within 2 days and should have our answer 5 to 7 days after that. we got our approval on Fri(10 days later). everytime i called after that they were very nice once they opened our file, and made sure to tell me it was marked urgent and being worked on. I had to change my appeal last minute, UHC director of complaints read me the notes they had and said they were very basic. same letter given about everyone. he said to make it specific about the boys and their needs. i emailed the our dr with exaclty what i wanted in the letters and made them redo them. I drove to dallas the next morning & picked them up. i also included a timeline for the past year, including dr visits and diagnosis,repo months, pt start how many a wk, all their delays and future appointments. i also included a bit of the runaround UHC gave us. For anyone still fighting the EVIL UHC, good luck. the only advise i can give is be specific about your child and your situation, dont let the dr be to basic or use the words " could develop " , or " most likely lead to " instead ask them to say that " it is developing " or " that it is leading to " i know its suttle but there is a diffence. also get your hr person involved or a lawyer if needed. but definitly raise a big stink. Good Luck. Misty~ & Isaac ~soon to be casted!! fort worth tx Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 22, 2004 Report Share Posted November 22, 2004 Misty I am so happy for you. i am glad you kept after them. Let us know how the casting goes. Angie and Jenna won our UHC appeal > > > yeah!!! we won our appeal from the EVIL UHC. just to remind you of > who we are, jacob & isaac 17mos(servere plagio & tort)we have been > in pt since march for tort, jacob was previously approved for a DOC > in April, and graduated sept 1. he needs another. Isaac was never > approved!!(same diagnosis & severity as jacob) we have been fighting > UHC for Isaac since April. 's 2nd rx was also denied(again for > cosmetic). we got the biggest run around, they actually told us they > never approved jacob's first DOC. even though it was already paid > for by them. we got alot of A told B but not C, who doesnt talk to > directly to B. get it! CONFUSING!! When we appealed jacob's first > DOC our nuero did a Peer to Peer with the UHC dr who was dening our > claim. when we tried to do that for his second they wouldnt let us, > said they dont do that. EVIL!! well when i got that call from our > dr, i called my hubby crying, and upset, we have been going through > this for months and the boys are getting so big. so it was hubby to > the rescue. lol. he called his hr person at work, and our lawyer, > and had a conference call with UHC director of complaint dept. he > told them of our run around(trust me this is the short version) and > time situation with the boys getting so old. We faxed our appeal > directly to him the next day. he said it would be to the review > board within 2 days and should have our answer 5 to 7 days after > that. we got our approval on Fri(10 days later). everytime i called > after that they were very nice once they opened our file, and made > sure to tell me it was marked urgent and being worked on. > I had to change my appeal last minute, UHC director of complaints > read me the notes they had and said they were very basic. same > letter given about everyone. he said to make it specific about the > boys and their needs. i emailed the our dr with exaclty what i > wanted in the letters and made them redo them. I drove to dallas the > next morning & picked them up. i also included a timeline for the > past year, including dr visits and diagnosis,repo months, pt start > how many a wk, all their delays and future appointments. i also > included a bit of the runaround UHC gave us. > For anyone still fighting the EVIL UHC, good luck. the only > advise i > can give is be specific about your child and your situation, dont > let the dr be to basic or use the words " could develop " , or " most > likely lead to " instead ask them to say that " it is developing " > or " that it is leading to " i know its suttle but there is a > diffence. also get your hr person involved or a lawyer if needed. > but definitly raise a big stink. Good Luck. > > Misty~ & Isaac ~soon to be casted!! > fort worth tx > > > > > > > For more plagio info Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 22, 2004 Report Share Posted November 22, 2004 HI Misty, CONGRATULATIONS!!!! All your hard work finally paid off...literally! Becky ('s mom) in Pgh, PA > > yeah!!! we won our appeal from the EVIL UHC. just to remind you of > who we are, jacob & isaac 17mos(servere plagio & tort)we have been > in pt since march for tort, jacob was previously approved for a DOC > in April, and graduated sept 1. he needs another. Isaac was never > approved!!(same diagnosis & severity as jacob) we have been fighting > UHC for Isaac since April. 's 2nd rx was also denied(again for > cosmetic). we got the biggest run around, they actually told us they > never approved jacob's first DOC. even though it was already paid > for by them. we got alot of A told B but not C, who doesnt talk to > directly to B. get it! CONFUSING!! When we appealed jacob's first > DOC our nuero did a Peer to Peer with the UHC dr who was dening our > claim. when we tried to do that for his second they wouldnt let us, > said they dont do that. EVIL!! well when i got that call from our > dr, i called my hubby crying, and upset, we have been going through > this for months and the boys are getting so big. so it was hubby to > the rescue. lol. he called his hr person at work, and our lawyer, > and had a conference call with UHC director of complaint dept. he > told them of our run around(trust me this is the short version) and > time situation with the boys getting so old. We faxed our appeal > directly to him the next day. he said it would be to the review > board within 2 days and should have our answer 5 to 7 days after > that. we got our approval on Fri(10 days later). everytime i called > after that they were very nice once they opened our file, and made > sure to tell me it was marked urgent and being worked on. > I had to change my appeal last minute, UHC director of complaints > read me the notes they had and said they were very basic. same > letter given about everyone. he said to make it specific about the > boys and their needs. i emailed the our dr with exaclty what i > wanted in the letters and made them redo them. I drove to dallas the > next morning & picked them up. i also included a timeline for the > past year, including dr visits and diagnosis,repo months, pt start > how many a wk, all their delays and future appointments. i also > included a bit of the runaround UHC gave us. > For anyone still fighting the EVIL UHC, good luck. the only > advise i > can give is be specific about your child and your situation, dont > let the dr be to basic or use the words " could develop " , or " most > likely lead to " instead ask them to say that " it is developing " > or " that it is leading to " i know its suttle but there is a > diffence. also get your hr person involved or a lawyer if needed. > but definitly raise a big stink. Good Luck. > > Misty~ & Isaac ~soon to be casted!! > fort worth tx Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 23, 2004 Report Share Posted November 23, 2004 CONGRATULATIONS!!! OMG you both had to do SO MUCH! You didn't deserve that aggravation at all. Good for you for following through. Thank you for sharing this and helping others. Please post pics whenever you are ready. Thanks! Sue Colin F., 14 mos. STARband grad > > yeah!!! we won our appeal from the EVIL UHC. just to remind you of > who we are, jacob & isaac 17mos(servere plagio & tort)we have been > in pt since march for tort, jacob was previously approved for a DOC > in April, and graduated sept 1. he needs another. Isaac was never > approved!!(same diagnosis & severity as jacob) we have been fighting > UHC for Isaac since April. 's 2nd rx was also denied(again for > cosmetic). we got the biggest run around, they actually told us they > never approved jacob's first DOC. even though it was already paid > for by them. we got alot of A told B but not C, who doesnt talk to > directly to B. get it! CONFUSING!! When we appealed jacob's first > DOC our nuero did a Peer to Peer with the UHC dr who was dening our > claim. when we tried to do that for his second they wouldnt let us, > said they dont do that. EVIL!! well when i got that call from our > dr, i called my hubby crying, and upset, we have been going through > this for months and the boys are getting so big. so it was hubby to > the rescue. lol. he called his hr person at work, and our lawyer, > and had a conference call with UHC director of complaint dept. he > told them of our run around(trust me this is the short version) and > time situation with the boys getting so old. We faxed our appeal > directly to him the next day. he said it would be to the review > board within 2 days and should have our answer 5 to 7 days after > that. we got our approval on Fri(10 days later). everytime i called > after that they were very nice once they opened our file, and made > sure to tell me it was marked urgent and being worked on. > I had to change my appeal last minute, UHC director of complaints > read me the notes they had and said they were very basic. same > letter given about everyone. he said to make it specific about the > boys and their needs. i emailed the our dr with exaclty what i > wanted in the letters and made them redo them. I drove to dallas the > next morning & picked them up. i also included a timeline for the > past year, including dr visits and diagnosis,repo months, pt start > how many a wk, all their delays and future appointments. i also > included a bit of the runaround UHC gave us. > For anyone still fighting the EVIL UHC, good luck. the only > advise i > can give is be specific about your child and your situation, dont > let the dr be to basic or use the words " could develop " , or " most > likely lead to " instead ask them to say that " it is developing " > or " that it is leading to " i know its suttle but there is a > diffence. also get your hr person involved or a lawyer if needed. > but definitly raise a big stink. Good Luck. > > Misty~ & Isaac ~soon to be casted!! > fort worth tx Quote Link to comment Share on other sites More sharing options...
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