Guest guest Posted October 28, 2004 Report Share Posted October 28, 2004 It is interesting. My company just switched from UHC to BCBS. The orthotist said we were lucky because UHC wasn't paying anymore but they USED TO. Maybe you could look into why they used to consider it a claim that they would pay but now don't. It seems like they should be called down for changing, because the health issue certainly didn't change. Janna St. Louis, MO Local Helmet Kellan's mom --- In Plagiocephaly , " sbcollns " <sbcollns@y...> wrote: > > Hi everyone. I am reading from everyone affiliated with UHC and how > people are being denied coverage for their child's helmet. I am in > the same position. I have UHC coverage and did not receive my > letter of denial in the mail yet. I am fully expecting a denial > letter based on what other members have been saying and reporting. > I am in the process of putting together some things that could help > me with my appeal letter. I have a letter from my neurologist > stating all of the medical reasons the helmet is needed for my > daughter. I am awaiting some legal advice and I was just wondering > if any of you could give me advice on what to put in my letter and > what else to send UHC. I would love if anyone could send me a copy > of their appeal letter so I could see it for reference. Does anyone > know of law suits that were taken up against UHC for this matter? I > would love any help b/c I plan on getting my wheels very very > squeeky. Thank you... > > Shari > mom to hannah 6 mos. > torticollis (PT) > plagiocephaly (being treated with hanger helmet) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 28, 2004 Report Share Posted October 28, 2004 Your initial denial of coverage will probably come in the form of a Explanation of Benefits (EOB). Cranial Tech should know whether your coverage was approved. In accordance with the EOB that you receive, request (in writing) for a copy of all documents related to the non-coverage decision. Also ask for all internal plans / policies / memorandums that are used to determine whether a procedure is cosmetic or orthotic. You'll need to know the basis of their denial before crafting your appeal. Good luck. --- In Plagiocephaly , " sbcollns " <sbcollns@y...> wrote: > > Hi everyone. I am reading from everyone affiliated with UHC and how > people are being denied coverage for their child's helmet. I am in > the same position. I have UHC coverage and did not receive my > letter of denial in the mail yet. I am fully expecting a denial > letter based on what other members have been saying and reporting. > I am in the process of putting together some things that could help > me with my appeal letter. I have a letter from my neurologist > stating all of the medical reasons the helmet is needed for my > daughter. I am awaiting some legal advice and I was just wondering > if any of you could give me advice on what to put in my letter and > what else to send UHC. I would love if anyone could send me a copy > of their appeal letter so I could see it for reference. Does anyone > know of law suits that were taken up against UHC for this matter? I > would love any help b/c I plan on getting my wheels very very > squeeky. Thank you... > > Shari > mom to hannah 6 mos. > torticollis (PT) > plagiocephaly (being treated with hanger helmet) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 28, 2004 Report Share Posted October 28, 2004 If you can find proof that it was covered for other children under a similar policy, you have a discrimination case. I have heard that as well and have asked various support groups for specific examples. I have not received anything yet. > > > > Hi everyone. I am reading from everyone affiliated with UHC and > how > > people are being denied coverage for their child's helmet. I am in > > the same position. I have UHC coverage and did not receive my > > letter of denial in the mail yet. I am fully expecting a denial > > letter based on what other members have been saying and reporting. > > I am in the process of putting together some things that could help > > me with my appeal letter. I have a letter from my neurologist > > stating all of the medical reasons the helmet is needed for my > > daughter. I am awaiting some legal advice and I was just wondering > > if any of you could give me advice on what to put in my letter and > > what else to send UHC. I would love if anyone could send me a copy > > of their appeal letter so I could see it for reference. Does > anyone > > know of law suits that were taken up against UHC for this matter? > I > > would love any help b/c I plan on getting my wheels very very > > squeeky. Thank you... > > > > Shari > > mom to hannah 6 mos. > > torticollis (PT) > > plagiocephaly (being treated with hanger helmet) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 28, 2004 Report Share Posted October 28, 2004 If you haven't already check the FILES/Insurance Help section. My letter, among others are there. My ins. is Independent Health. Also, in the database section there is a spreadsheet for who's insurance pd. what. GOOD LUCK! Sue Colin F., 13 mos. STARband grad for brachy --- In Plagiocephaly , " sbcollns " <sbcollns@y...> wrote: > > Hi everyone. I am reading from everyone affiliated with UHC and how > people are being denied coverage for their child's helmet. I am in > the same position. I have UHC coverage and did not receive my > letter of denial in the mail yet. I am fully expecting a denial > letter based on what other members have been saying and reporting. > I am in the process of putting together some things that could help > me with my appeal letter. I have a letter from my neurologist > stating all of the medical reasons the helmet is needed for my > daughter. I am awaiting some legal advice and I was just wondering > if any of you could give me advice on what to put in my letter and > what else to send UHC. I would love if anyone could send me a copy > of their appeal letter so I could see it for reference. Does anyone > know of law suits that were taken up against UHC for this matter? I > would love any help b/c I plan on getting my wheels very very > squeeky. Thank you... > > Shari > mom to hannah 6 mos. > torticollis (PT) > plagiocephaly (being treated with hanger helmet) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 28, 2004 Report Share Posted October 28, 2004 If the members with UHC could find cases of where they covered it in the past you could say they were discrimating against you >From: " Janna " <babykellan@...> >Reply-Plagiocephaly >Plagiocephaly >Subject: Re: UHC- insurance denial >Date: Thu, 28 Oct 2004 13:42:33 -0000 > > >It is interesting. My company just switched from UHC to BCBS. The >orthotist said we were lucky because UHC wasn't paying anymore but >they USED TO. Maybe you could look into why they used to consider it >a claim that they would pay but now don't. It seems like they should >be called down for changing, because the health issue certainly >didn't change. > >Janna >St. Louis, MO >Local Helmet >Kellan's mom > > > >--- In Plagiocephaly , " sbcollns " <sbcollns@y...> >wrote: > > > > Hi everyone. I am reading from everyone affiliated with UHC and >how > > people are being denied coverage for their child's helmet. I am in > > the same position. I have UHC coverage and did not receive my > > letter of denial in the mail yet. I am fully expecting a denial > > letter based on what other members have been saying and reporting. > > I am in the process of putting together some things that could help > > me with my appeal letter. I have a letter from my neurologist > > stating all of the medical reasons the helmet is needed for my > > daughter. I am awaiting some legal advice and I was just wondering > > if any of you could give me advice on what to put in my letter and > > what else to send UHC. I would love if anyone could send me a copy > > of their appeal letter so I could see it for reference. Does >anyone > > know of law suits that were taken up against UHC for this matter? >I > > would love any help b/c I plan on getting my wheels very very > > squeeky. Thank you... > > > > Shari > > mom to hannah 6 mos. > > torticollis (PT) > > plagiocephaly (being treated with hanger helmet) > > > _________________________________________________________________ Don’t just search. Find. Check out the new MSN Search! http://search.msn.click-url.com/go/onm00200636ave/direct/01/ Quote Link to comment Share on other sites More sharing options...
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