United Healthcare-How do I demonstrate a physiological functional impairment?

[Guest guest]

Hi, my son just graduated from his DOC band last week after 3.5

months in the band. Unfortunately, we are still fighting with our

insurance company (United Healthcare) to get them to cover it. I

already downloaded one of the appeal letters off this site and

modified it to fit him and had his pediatrician write a letter

recommending DOC band treatment. UH denied coverage again. It states

in their denial letter that in order for this service to be considered

for coverage, you must submit medical records that demonstrate a

physiological functional impairment, along with an explanation showing

how this service improves or resolves such functional impairments and

meets the requirements indicated in your benefit plan language. Does

anyone know how I go about demonstrating physiological functional

impairment? His pediatrician did order a CAT scan when was 3

months old because she was concerned his sutures were closing

prematurely but it showed they were o.k. It makes me so mad that they

won't cover this! Any tips would be appreciated.

, Mom to , 9 months