United HealthCare

[Guest guest]

I called our insurance (Kaiser) to see if it was covered for us. They said it all depends if you have that added to the policy - which it turns out dh's company had that coverage - so we have 80% coverage for a helmet. The only problem now is getting them to see what I see. And to prescribe one. @@

Jen

Mommy to 4...and 1 more!!!!

LULI'S HERE!

"Luli"

www.babiesonline.com/babies/j/jens5th/

[Guest guest]

Ours is still pending, but I have a feeling we'll be denied just like

everyone else! So far, I have been less than impressed with this

insurance. Oh well....

>

> Hello all! I am still looking for anyone who has had success with

> United healthcare covering a STARband. If there is anyone out there

> please let me know.

>

> Thanks,

>

>

[Guest guest]

We just got our denial letter from UHC for our DOC band. Haven't yet

decided if we will appeal. It is really discouraging that they think

it is cosmetic.

Bobbi

5 mos. tort/plagio

Phx

>

> Hello all! I am still looking for anyone who has had success with

> United healthcare covering a STARband. If there is anyone out there

> please let me know.

>

> Thanks,

>

>

[Guest guest]

i don't have UHC, but did either of you have your consulting

specialist submit a letter of medical necessity for necessary

medical equipment? My docs didn't think to do this, but I asked them

to, and our insurance covered it. I hope that helps! Keep fighting!!

> >

> > Hello all! I am still looking for anyone who has had success

with

> > United healthcare covering a STARband. If there is anyone out

there

> > please let me know.

> >

> > Thanks,

> >

> >

>

[Guest guest]

,

I will send you my contact info in hopes that it will help, although I may not

be the best

person. I have a huge stack of documentation demonstrating UHC acting in bad

faith, and

I am fighting them tooth and nail.

My daughter had severe plagio with corresponding facial asymmetry. UHC did

cover her

Starband but we had major problems and our 2nd band was a DOC Band. UHC refused

to

cover the DOC Band citing orthotics exclusion and, once, denied it as a penalty

for failing

to contact care coordination. I proved contact and they went back to orthotics

exclusion.

(I've noticed that UHC has now added the specific words " cranial banding " under

exclusions in my updated policy to try to circumvent requests/appeals.)

I now have a lawyer, a teachers association, a senator, and contacts at the

state insurance

commission helping me, and I am going to fight this fight on behalf of all

plagio babies

being denied coverage by UHC.

>

> Hello all! I am still looking for anyone who has had success with

> United healthcare covering a STARband. If there is anyone out there

> please let me know.

>

> Thanks,

>

>

[Guest guest]

,

I was so excited to see your post about sucessfully fighting UHC. We're in the process now. I would love any advice you could give? What type of letter did you compose? What type of supporting evidence did you include? What was their reasoning behind the denial? HOw did you respond directly to that reasoning? Would you mind if I called you to ask questions? I would really appreciate any help you could give me. The helmet will cost us $3750 if UHC won't pay.

281-256-7530

From: "tvanhout" <rlwyse@...>Reply-Plagiocephaly To: Plagiocephaly Subject: United healthcareDate: Thu, 06 Jul 2006 03:01:00 -0000

Hello all! I just wanted to thank those of you who supported me in my fight with United- Especially those of you that let me use your names. I just wanted to let everyone know that United just came through with 80% for our daughter's STARband. We are thrilled of course!

[Guest guest]

That is wonderful! CONGRATS!

Jen

(23 mo), tort resolved, Hanger Band Grad

(4.5 years)

>

> Hello all! I just wanted to thank those of you who supported me in

my

> fight with United- Especially those of you that let me use your

names.

> I just wanted to let everyone know that United just came through

with

> 80% for our daughter's STARband. We are thrilled of course!

>

>

[Guest guest]

,

I am also starting my fight with UHC. Any detail and tips you could

provide would be great. We are in the process of consulting an

attorney (a family friend) about how to best put the appeal together.

Thanks

Mandy,

Herriman, UT

[Guest guest]

That is so great!!! Can I e-mail you to find out more? We have

been denied by UHC and I have been putting off the appeal. It is

time to do it! My e-mail is rices@... if you need it!

Thanks!

Sophia - 13 months - STAR helmet 3/15/06

> >

> > Hello all! I just wanted to thank those of you who supported me

in

> my

> > fight with United- Especially those of you that let me use your

> names.

> > I just wanted to let everyone know that United just came through

> with

> > 80% for our daughter's STARband. We are thrilled of course!

> >

> >

>

[Guest guest]

Mandy,

I'm not , but I am fighting UHC. I've done some research and would be willing to help you out any way I can. It probably won't be much compared to what the attorney can do for you. I'd love to hear what he/she has to say about your appeal. We've considered consulting an attorney as well, but would have to pay for ours. Let me know if there is anything I can help you with. What reason are they giving you for denial?

VAlerie

From: "lillybeans820" <lillybeans820@...>Reply-Plagiocephaly To: Plagiocephaly Subject: Re: United healthcareDate: Thu, 06 Jul 2006 16:35:19 -0000

,I am also starting my fight with UHC. Any detail and tips you could provide would be great. We are in the process of consulting an attorney (a family friend) about how to best put the appeal together. ThanksMandy, Herriman, UT

[Guest guest]

UHC told me that it wasnt under durable medical equipment, that my hanger helmet was under something else. the HCPC code had to be looked at individually. do any of you know about this? i was already denied and we will appeal but just curious. Getting a letter from helmet place tomorrow when we pick it up.

I had someone from UHC at one point tell me it was for sure covered under DME but then every other person said no, no no! ugh.

also Hanger said they will bill insurance anyway. she says 7 out of 10 times, it is just pushed thru anyway because someone else looks thru it.

I save all the UHC emails so keep them coming!

--------- So irritated with United HealthCare right now....

Ugh, I hate this insurance stuff. We began treatment back in May after we received a denial from UHC. In the denial letter it said I could request the reasons for denial (internal policies and protocols, etc). So I called and made the request (they were supposed to respond within 15 days). A month went by and nothing. So I called again and was told the request had to be made in writing. GRRRR, why didn't the person with whom I made the original request tell me that? So I made the request in writing (via fax). Three more weeks and NOTHING. So I got tired of waiting and filled out the forms and sent in my appeal letter and packet (return receipt). We were supposed to get a response within 30 days. Friday was 32 days, so I called. The guy I talked to said that because there was no BILL from the provider, the person who got my appeal didn't know what to do with it and kicked it out of the system. Well, the provider didn't s

ubmit a bill because the preapproval was denied and we paid out of pocket, there was no reason to submit a bill for something that was rejected. So my appeal sat there for 30 days and they did NOTHING with it! So the UHC guy told me to have the provider submit the BILL, THEN wait for the rejection, THEN tell them that they already had my appeal and I'd have to wait another 30 days. NO WAY! I asked to speak to a supervisor and told her that UHC was in breach of contract with me because they hadn't followed ANY of their procedures - they hadn't sent me the reasons for denial within 15 days, they hadn't responded to my appeal within 30 days, they were ignoring me and I wasn't going to wait another 30 days. So she said they would be mailing me the internal policy for DOC bands (we'll see if I ever get it) and that she was sending the appeal BACK to the guy who was supposed to review it with a note that he do so now, explaining tha

t we'd been denied based on preapproval. So tomorrow I have to get the bill submitted and she told me to call back by Friday for an answer. Somehow I'm betting it won't be good news but at least then I can move on to the next step and request an external review. Anyway, I should've been like the other posters and called more often. Every time I called I'd get a different story. So I pretty much am just going to ask to speak to a supervisor from now on. Good luck to everyone who is going through the appeals process...Cris in Houston Mom to - 9 monthsDOC band Graduate 7.25.06

[Guest guest]

I actually have Pacificare, but I was told it's not under durable med. equipment for them either. In fact, no one can find it in the coverage. What's even more interesting is that they said they couldn't tell me the preferred provider... that once the pediatrician gave us an rx, she would give us a list of people we could go through. Found that kind of funny that the insurance company couldn't tell me who we can use, but our ped. can?! Whatever. Somedays they really frustrate me. Good luck with your appeal. Let us know how it turns out. Candace, AZ mommy to Tiernan, 4 mos tort, plagiolepf@... wrote: UHC told me that it wasnt under durable medical equipment, that my hanger helmet was under something else. the HCPC code had to be looked at individually. do any of you know about this? i was already denied and we will appeal but just curious. Getting a letter from helmet place tomorrow when we pick it up. I had someone from UHC at one point tell me it was for sure covered under DME but then every other person said no, no no! ugh. also Hanger said they will bill insurance anyway. she says 7 out of 10 times, it is just pushed thru anyway because someone else looks thru it. I save all the UHC emails so keep them coming! --------- So irritated with United HealthCare right now.... Ugh, I hate this insurance stuff. We began treatment back in May after we received a denial from UHC. In the denial letter it said I could request the reasons for denial (internal policies and protocols, etc). So I called and made

the request (they were supposed to respond within 15 days). A month went by and nothing. So I called again and was told the request had to be made in writing. GRRRR, why didn't the person with whom I made the original request tell me that? So I made the request in writing (via fax). Three more weeks and NOTHING. So I got tired of waiting and filled out the forms and sent in my appeal letter and packet (return receipt). We were supposed to get a response within 30 days. Friday was 32 days, so I called. The guy I talked to said that because there was no BILL from the provider, the person who got my appeal didn't know what to do with it and kicked it out of the system. Well, the provider didn't s ubmit a bill because the preapproval was denied and we paid out of pocket, there was no reason to submit a bill for something that was rejected. So my appeal sat there for 30 days and they did NOTHING with it! So the UHC

guy told me to have the provider submit the BILL, THEN wait for the rejection, THEN tell them that they already had my appeal and I'd have to wait another 30 days. NO WAY! I asked to speak to a supervisor and told her that UHC was in breach of contract with me because they hadn't followed ANY of their procedures - they hadn't sent me the reasons for denial within 15 days, they hadn't responded to my appeal within 30 days, they were ignoring me and I wasn't going to wait another 30 days. So she said they would be mailing me the internal policy for DOC bands (we'll see if I ever get it) and that she was sending the appeal BACK to the guy who was supposed to review it with a note that he do so now, explaining tha t we'd been denied based on preapproval. So tomorrow I have to get the bill submitted and she told me to call back by Friday for an answer. Somehow I'm betting it won't be good news but at least then I can move

on to the next step and request an external review. Anyway, I should've been like the other posters and called more often. Every time I called I'd get a different story. So I pretty much am just going to ask to speak to a supervisor from now on. Good luck to everyone who is going through the appeals process...Cris in Houston Mom to - 9 monthsDOC band Graduate 7.25.06

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[Guest guest]

Cris -

We have UHC too (unfortunately and they've already advised that they

will deny our claim. We haven't even had our casting yet (scheduled

for 9/12). They denied based on prenotification - how terrible is

that! Anyway, the code the CT told me to use is S1040 - which is a

cranial remolding device - HTH.

Donna

, 7.5 months, brachy baby (DOC Band Casting 9/12)

[Guest guest]

that is the code i have as well.

mine was denied however they put my husbands name as the patient and my hanger place is submitting to them anyway and she thinks it will be approved because they didnt have son's name in there. also she says many times it is approved even after predetermination is denied because another person is looking at it.

-------------- Original message -------------- From: "Donna" <tobykc@...>

Cris -We have UHC too (unfortunately and they've already advised that they will deny our claim. We haven't even had our casting yet (scheduled for 9/12). They denied based on prenotification - how terrible is that! Anyway, the code the CT told me to use is S1040 - which is a cranial remolding device - HTH.Donna, 7.5 months, brachy baby (DOC Band Casting 9/12)

[Guest guest]

>

> Has anyone recently had United Healthcare cover a STARband in

Florida?

> If so, what did you do to get them to approve it?

>

> I will be going to Prosthetic and Orthotic Associates in Orlando and

> they informed UHC has not covered a band in the last two years.

> However, I am still trying to get UHC to approve it. They have not

> denied it yet, but they informed me that since I am going Out of

> Network, they probably won't cover it (they do not have an In Network

> provider in the state of Florida).

>

> Thanks,

> and Aubrey (4 months)

>

[Guest guest]

Congratulations on your son's successful treatment! We have UHC and

are currently in the process of appealing (waiting to hear back

after our first appeal). Do you know where your specialist got the

information she mentioned about UHC changing their policy? If not,

would you be able to give me the phone number to his/her office so I

could call and ask? I'd love to be able to reference it if we get

denied again.

THANKS!!!

Lori

Mom to , 9 months

DOC Band grad July 07

>

> Some information I found out today. We have United Healthcare

EPO.

> Last Nov when we got the referral from our ped for the

craniofacial

> specialist, we were warned that United Healthcare historically did

> not, would not, had not, paid for the DOC band. We decided that

no

> matter what, our son needed the band, so we went on the payment

plan

> with Cranial Tech and got the process started in February (in Nov

the

> first avail for craniofacial specialist was Jan 25th - uggh, so

> didn't see Cranial Tech til first week of Feb - hated waiting and

> losing time). We hoped and prayed maybe, maybe they'd pay, but if

> not, we'd figure out some way to make it happen on our side.

Well,

> along came April, and an appeal later, we got a wonderful letter

in

> the mail saying that United Healthcare would pay all but the $200

> copay! How's that for an answer to prayer?

> At his exit appt today with the craniofacial specialist, we

> discussed the insurance paying, and she said that starting in

April

> 2000, United Healthcare switched their position on the bands, and

> started paying.

> Hopefully this will be good news to somebody!

> p.s.

> 's head reshaped beautifully - we are extremely pleased -

it

> takes a careful study to see a couple areas that didn't get all

the

> way reshaped before he outgrew the band.

> p.p.s.

> As part of the appeal process, we got my husband's company's

human

> resource dept involved - turned out they had two other families

going

> thru same process - there was strength in numbers I believe, and

> strength in coming from the HR insurance dept. Can't hurt to get

> anyone involved that will plead your case for you.

>

[Guest guest]

I second Lori's request for more info concerning UHC

appeals!

Thanks!

--- lncslp <lncslp@...> wrote:

> Congratulations on your son's successful treatment!

> We have UHC and

> are currently in the process of appealing (waiting

> to hear back

> after our first appeal). Do you know where your

> specialist got the

> information she mentioned about UHC changing their

> policy? If not,

> would you be able to give me the phone number to

> his/her office so I

> could call and ask? I'd love to be able to

> reference it if we get

> denied again.

>

> THANKS!!!

> Lori

> Mom to , 9 months

> DOC Band grad July 07

>

>

>

> >

> > Some information I found out today. We have

> United Healthcare

> EPO.

> > Last Nov when we got the referral from our ped for

> the

> craniofacial

> > specialist, we were warned that United Healthcare

> historically did

> > not, would not, had not, paid for the DOC band.

> We decided that

> no

> > matter what, our son needed the band, so we went

> on the payment

> plan

> > with Cranial Tech and got the process started in

> February (in Nov

> the

> > first avail for craniofacial specialist was Jan

> 25th - uggh, so

> > didn't see Cranial Tech til first week of Feb -

> hated waiting and

> > losing time). We hoped and prayed maybe, maybe

> they'd pay, but if

> > not, we'd figure out some way to make it happen on

> our side.

> Well,

> > along came April, and an appeal later, we got a

> wonderful letter

> in

> > the mail saying that United Healthcare would pay

> all but the $200

> > copay! How's that for an answer to prayer?

> > At his exit appt today with the craniofacial

> specialist, we

> > discussed the insurance paying, and she said that

> starting in

> April

> > 2000, United Healthcare switched their position on

> the bands, and

> > started paying.

> > Hopefully this will be good news to somebody!

> > p.s.

> > 's head reshaped beautifully - we are

> extremely pleased -

> it

> > takes a careful study to see a couple areas that

> didn't get all

> the

> > way reshaped before he outgrew the band.

> > p.p.s.

> > As part of the appeal process, we got my

> husband's company's

> human

> > resource dept involved - turned out they had two

> other families

> going

> > thru same process - there was strength in numbers

> I believe, and

> > strength in coming from the HR insurance dept.

> Can't hurt to get

> > anyone involved that will plead your case for you.

> >

>

>

>

________________________________________________________________________________\

____

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[Guest guest]

I also have United HealthCare and was denied from the pre-determination process. We are still in the process of appealing it...(our 1st appeal). The denial stated that the band isn't covered b/c it's not in our benefit plan. For those that have UHC and was given approval, do you have any suggestions for me in my appeal process? We have the documents from the doctors and physical therapist stating their findings and recommendations for my son to have the helmet. We also have pictures to show them. Are we missing anything? I did look under sample UHC folders in this website...I believe it was under "File." Anyhow, any help would be appreciated. THanks, Mom to Austin, 7 months In Helmet for 2 weekslncslp <lncslp@...> wrote: Congratulations on your son's successful treatment! We have UHC and are currently in the process of appealing (waiting to hear back after our first appeal). Do you know where your specialist got the information she mentioned about UHC changing their policy? If not, would you be able to give me the phone number to his/her office so I could call and ask? I'd love to be able to reference it if we get denied again. :)THANKS!!!LoriMom to , 9 monthsDOC Band grad July 07>> Some information I found out today. We have United Healthcare EPO. > Last Nov when we got the referral from our ped for the craniofacial > specialist, we were warned that United Healthcare historically did > not, would not, had not, paid for the DOC band. We decided that no > matter what, our son needed the band, so we went on the payment plan > with Cranial Tech and got the process started in February (in Nov the > first avail for craniofacial specialist was Jan 25th - uggh, so > didn't see Cranial Tech til first week of Feb - hated waiting and > losing time). We hoped and prayed maybe, maybe they'd pay, but if > not, we'd figure out some way to make it happen on our side. Well, > along came April, and an appeal later, we got a wonderful letter in > the mail saying that United Healthcare would pay all but the $200 > copay! How's that for

an answer to prayer?> At his exit appt today with the craniofacial specialist, we > discussed the insurance paying, and she said that starting in April > 2000, United Healthcare switched their position on the bands, and > started paying.> Hopefully this will be good news to somebody!> p.s.> 's head reshaped beautifully - we are extremely pleased - it > takes a careful study to see a couple areas that didn't get all the > way reshaped before he outgrew the band.> p.p.s.> As part of the appeal process, we got my husband's company's human > resource dept involved - turned out they had two other families going > thru same process - there was strength in numbers I believe, and > strength in coming from the HR insurance dept. Can't hurt to get > anyone involved that will plead your case for

you.>

oneSearch: Finally, mobile search that gives answers, not web links.

[Guest guest]

,

Although you are further along in the process than we are I would

recommend reviewing your policy. I have United Healthcare as well;

however, there are many different policy depending on your employer.

When I reviewed the information, custom made orthotics was a covered

benefit; however, when I called the Customer Service plan and

inquired about it. It was considered " Durable Medical Equipment " .

Using this provision, it would be covered " in-network " . However, I

have checked with the in-network providers, and of course, there

aren't any who supply, or contracted out for the helmets. I have

already researched in the event that we are denied. I hope this help

ever so slightly.

Re: Re: United Healthcare

I also have United HealthCare and was denied from the pre-

determination process. We are still in the process of appealing it...

(our 1st appeal). The denial stated that the band isn't covered b/c

it's not in our benefit plan. For those that have UHC and was given

approval, do you have any suggestions for me in my appeal process?

We have the documents from the doctors and physical therapist stating

their findings and recommendations for my son to have the helmet. We

also have pictures to show them. Are we missing anything? I did look

under sample UHC folders in this website...I believe it was

under " File. " Anyhow, any help would be appreciated.

THanks,

Mom to Austin, 7 months

In Helmet for 2 weeks

[Guest guest]

Hi ,

I too have United Health Care and was told that the

band is not covered when I called them. My son is 7

months now, with moderate plagio and tort. Would

appreciate if you could forward me your appeal

letter!!

Thanks!!!

Sue

San

--- lka_236 <lka_236@...> wrote:

> Email me if you'd like a copy of my sucessful appeal

> w/ UHC.

>

> lka_236@...

>

>

>

>

> >

> > From: <melissakyleclark@...>

> > Subject: Re: United Healthcare

> > Plagiocephaly

> > Date: Sunday, March 30, 2008, 2:21 PM

> >

> >

> > I have just spoken to them and our plan does not

> cover

> > orthotics. that is what the band is considered.

> you

> > will need to specifically ask for that if it is in

> > your plan. your plan is a contract between the

> > employer and the insurance company and they are

> > telling me even an appeal would not go through.

> >

> > United Healthcare

> >

> >

> > Does anybody have UnitedHealthcare. I was trying

> to

> > figure out whether

> > the DOC Band is covered, before we go for our

> > appointment at CT, but I

> > could not find information. I am planning on

> calling

> > them on Monday,

> > but wanted to check if anybody has had experience

> with

> > them. Thank you

> > in advance.

> >

> >

> >

> >

> >

> >

> >

> >

> >

> > ---------------------------------

> > Like movies? Here's a limited-time offer:

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> >

> >

> > ---------------------------------

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> >

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> >

> >

> >

> >

>

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> _______________

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> > Find them fast with Search.

>

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> >

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>

>

[Guest guest]

I was just on the other plagio board and a mom posted with a really

good piece of advice. She was dealing with Tricare (which I believe

is through the military) and she was told over and over again by the

billing specialist at the ortho that the band would not be covered

by Tricare. But she pushed and pushed and told her to file her claim

anyway and ended up getting a full reimbursement for the band, no

questions asked. So her advice was to file the claim/bill no matter

what! And another mom responded that you can't actually appeal until

you have a letter of denial from an unsuccessful claim first. So I

just wanted to pass that along to anyone thinking of not even filing

the claim if you don't believe it's covered, because you never

know...it doesn't hurt to try!

Good luck!

Jake-18m (tort resolved/rt plagio/DocBand 2/11/08)

Jordan-4

> >

> > From: <melissakyleclark@>

> > Subject: Re: United Healthcare

> > Plagiocephaly

> > Date: Sunday, March 30, 2008, 2:21 PM

> >

> >

> > I have just spoken to them and our plan does not cover

> > orthotics. that is what the band is considered. you

> > will need to specifically ask for that if it is in

> > your plan. your plan is a contract between the

> > employer and the insurance company and they are

> > telling me even an appeal would not go through.

> >

> > United Healthcare

> >

> >

> > Does anybody have UnitedHealthcare. I was trying to

> > figure out whether

> > the DOC Band is covered, before we go for our

> > appointment at CT, but I

> > could not find information. I am planning on calling

> > them on Monday,

> > but wanted to check if anybody has had experience with

> > them. Thank you

> > in advance.

> >

> >

> >

> >

> >

> >

> >

> >

> >

> > ---------------------------------

> > Like movies? Here's a limited-time offer: Blockbuster

> > Total Access for one month at no cost.

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> >

> >

> > ---------------------------------

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> >

> >

> >

> >

>

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> _______________

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> >

>

[Guest guest]

I would like this and can receive it at melissakyleclark@.... they told me they have never seen an appeal go through. did your policy consider orthotics to reshape a body part and exclusion? that is what they are calling the band for our little guy. thank you so much for sharing your info and congrats on your successful appeal.

United Healthcare> > > Does anybody have UnitedHealthcare. I was trying to> figure out whether > the DOC Band is covered, before we go for our> appointment at CT, but I > could not find information. I am planning on calling> them on Monday, > but wanted to check if anybody has had experience with> them. Thank you > in advance.>

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[Guest guest]



,

I too was denied from UHC for the same reason. Have you requested the "Explanation of the scientific basis and clinical judgment that was relied upon in making the non--coverage decision?" I'm working on a appeal with a attorney friend of mine. He suggested requesting this before I file my appeal. Our claim was originally denied for "Plan does not cover durable medical equipment that changes the shape of a body part." We like yourself paid for the band out of pocket and are hoping for a reimbursement.

Let me know if you get anywhere with UHC.

Lorie

Mom to Spencer and Alizabeth 11 months

Spencer- Left side Plagio- DOC Band Grad 9/07-12/07

Glendale,AZ> > From: <melissakyleclark@...>> Subject: Re: United Healthcare> Plagiocephaly > Date: Sunday, March 30, 2008, 2:21 PM> > > I have just spoken to them and our plan does not cover> orthotics. that is what the band is considered. you> will need to specifically ask for that if it is in> your plan. your plan is a contract between the> employer and the insurance company and they are> telling me even an appeal would not go through. > > United Healthcare> > > Does anybody have UnitedHealthcare. I was trying to> figure out whether > the DOC Band is covered, before we go for our> appointment at CT, but I > could not find information. I am planning on calling> them on Monday, > but wanted to check if anybody has had experience with> them. Thank you > in advance.> > > > > > > > > > ---------------------------------> Like movies? Here's a limited-time offer: Blockbuster> Total Access for one month at no cost. > > > > ---------------------------------> Like movies? Here's a limited-time offer: Blockbuster> Total Access for one month at no cost.> > > > > > _________________________________________________________________________> Looking for last minute shopping deals? > Find them fast with Search. http://tools.search./newsearch/category.php?category=shopping> Messages in this topic (31) Reply (via web post) | Start a new topic Messages | Files | Photos | Links | Database | Polls | Members For more plagio info

[Guest guest]

I did call and request this info and they acted like I

was crazy. I went on to explain myself, and they told

me that they didn't have this info as it is clearly

identified as an exclusion to my policy. Ironically,

my husband is switching jobs, and we are switching to

Humana insurance, which the people at Hanger say they

never have problems with. The girl that was working

that day also said that she has only ever had one UHC

claim go through. I was very dissatisfied with all

the customer service I received from UHC and will be

so happy when this whole thing is over.

Mom to , 9 months, severe brachy

Will receive Hanger band 4/7/08

--- Lorie Fitzgerald <lfitz_1@...> wrote:

> ,

> I too was denied from UHC for the same reason.

> Have you requested the " Explanation of the

> scientific basis and clinical judgment that was

> relied upon in making the non--coverage decision? "

> I'm working on a appeal with a attorney friend of

> mine. He suggested requesting this before I file my

> appeal. Our claim was originally denied for " Plan

> does not cover durable medical equipment that

> changes the shape of a body part. " We like yourself

> paid for the band out of pocket and are hoping for a

> reimbursement.

> Let me know if you get anywhere with UHC.

>

> Lorie

> Mom to Spencer and Alizabeth 11 months

> Spencer- Left side Plagio- DOC Band Grad 9/07-12/07

> Glendale,AZ

>

>

>

>

>

>

> >

> > From: <melissakyleclark@...>

> > Subject: Re: United Healthcare

> > Plagiocephaly

> > Date: Sunday, March 30, 2008, 2:21 PM

> >

> >

> > I have just spoken to them and our plan does not

> cover

> > orthotics. that is what the band is considered.

> you

> > will need to specifically ask for that if it is in

> > your plan. your plan is a contract between the

> > employer and the insurance company and they are

> > telling me even an appeal would not go through.

> >

> > United Healthcare

> >

> >

> > Does anybody have UnitedHealthcare. I was trying

> to

> > figure out whether

> > the DOC Band is covered, before we go for our

> > appointment at CT, but I

> > could not find information. I am planning on

> calling

> > them on Monday,

> > but wanted to check if anybody has had experience

> with

> > them. Thank you

> > in advance.

> >

> >

> >

> >

> >

> >

> >

> >

> >

> > ---------------------------------

> > Like movies? Here's a limited-time offer:

> Blockbuster

> > Total Access for one month at no cost.

> >

> >

> >

> > ---------------------------------

> > Like movies? Here's a limited-time offer:

> Blockbuster

> > Total Access for one month at no cost.

> >

> >

>

> >

> >

> >

> >

>

__________________________________________________________

> _______________

> > Looking for last minute shopping deals?

> > Find them fast with Search.

>

http://tools.search./newsearch/category.php?

> category=shopping

> >

>

>

>

>

> Messages in this topic (31) Reply (via web post) |

> Start a new topic

> Messages | Files | Photos | Links | Database | Polls

> | Members

> For more plagio info, go to

> www.plagiocephaly.org/support

>

[Guest guest]

Hi , as i said in one of my previous postings my doctor is telling me that there is nothing wrong with my son's head, but I can see that there is a flat spot on the back. When you look at him from front or back it looks really good, but from the side you can see the spot. She is trying to convince me that it will go away once he starts sitting, etc.but I do not want to take any chances and I want him checked, especially as I have personal experience and my head is not really symmetrical either . I have an appointment with CT in NJ tomorrow, so will see what they will say, but I wanted to be prepare when I go there so I am doing all the research...So I called UnitedHealthcare and they are telling me that Hangar is covered 100%, but CT is not (only 70%). I will let you know what they says tomorrow and I guess then I will have to make a decision, but I still hope that they will give me good news, that there is no need for a band. Thanks, Totticathyl65 <cathyl65@...> wrote: Hi Parusheva (sorry i did not know your first name), I am one of the moms on this board that had a bad experience with Hanger in Long Island. My son wore an ill fitting helmet from them from the age of 5-10mo. before he went into the Doc Band at the age of 14months. Waste of valuable precious time when he was banded with Hanger. He did get pretty good correction with the Doc Band but not 100% due to his age at the time. Where in NY are you located? Which hangar

facility did you plan on using?If you have any questions please feel free to ask!Best of luck 2 you! - Mom to CJ - 2yrs & 1mo oldDoc Band Graduate 9/2007So many of us in the long island nyc area went to CT after some advice and bad experiences with Hanger. I would go to CT no doubt perhaps you can talk to or on this site who both had negative, time wasting experiences at Hanger in Long Island. Tammy It is hit or miss. It all depends on your policy. UHC didn't cover our doc band. We are working on a appeal to get a reimbursement. Best of luck with UHC, let

us know how it goes.LorieMom to Spencer and Alizabeth 11 moSpencer- Left Plagio- DOC Band GRAD 9/07-12/07AZ [sPAM] Re: United HealthcareWe have UnitedHealthcare too. They are a hit or miss in coverage. You will definetly want to contact them. We decided to pay upfront and try to get reimburssed after. We did that because it would take a month or longer just for the approval process. We wanted to get the band on asap before our son got older. Good luck. I hope they cover some or all of your band.Jenn>> Does anybody have UnitedHealthcare. I was trying to figure out

whether > the DOC Band is covered, before we go for our appointment at CT, but I > could not find information. I am planning on calling them on Monday, > but wanted to check if anybody has had experience with them. Thank you > in advance.

You rock. That's why Blockbuster's offering you one month of Blockbuster Total Access, No Cost.