Need Help with United Health Care

[Guest guest]

Hi Everyone,

My son Spencer Graduated from his DOC Band in December. For some reason or another, we just got word (via the phone) that United Health Care has denied our claim to pay for the DOC band. I haven't received the official notice in the mail yet, so I don't know the basis of their denial. I've collected some information to help support my claim. But it would be helpful to look at someone's successful appeal, before I draft mine. One other thing. Would you recommended hiring an attorney to draft the letter and help out with the appeal?

Thank you for your help

Lorie

[Guest guest]

UHC always denies. You should definitely appeal. There are sample

letters in the files section of this group. There have been successful

appeals against UHC, but I think they assume most people won't bother,

so they keep the cost lower by routinely denying. Just my opinion of

course, but I've seen so many UHC denials while in this group.

-christine

sydney 2 yrs starband grad

>

> Hi Everyone,

> My son Spencer Graduated from his DOC Band in December. For some

reason or another, we just got word (via the phone) that United Health

Care has denied our claim to pay for the DOC band. I haven't received

the official notice in the mail yet, so I don't know the basis of

their denial. I've collected some information to help support my

claim. But it would be helpful to look at someone's successful appeal,

before I draft mine. One other thing. Would you recommended hiring an

attorney to draft the letter and help out with the appeal?

>

> Thank you for your help

>

> Lorie

>

[Guest guest]

Were you originally told that you would be approved? Was it in writing? Definitely check out the appeals in the files section -- there are some awesome letters there. Before writing your appeal, jot down chronology for yourself (including times you spoke/wrote to UHC). Not sure if you needed to do PT for tort or anything, but if you have pictures of stretching exersises, or of repositioning attempts, etc. you can present those with the packet. Considering the band was probably around 3K, hiring a lawyer would probably not be cost effective in this case -- although that is totally up to you and your comfort level. Some here would probably be willing to read your letter -- I'd be one of those people. Insurance companies count on people getting worn down. Others have devised criteria for treatment (measurements, etc.) -- others say they will not covered at all. So knowing your policy would b

e a good start. Some ideas can be found here, too -- though this was put together in 2000, so some information might not be applicable now... http://www.plagiosupport.org/insurance.htm a.k.a. "Kali"mom to Quinn, born 11/99, DOCband grad for scaphocephalic head shape 10/00>------- Original Message ------->From : christineashok[mailto:christineashok@...]>Sent : 1/25/2008 2:04:23 AM>To : Plagiocephaly >Cc : >Subject : RE: Re: Need Help with United Health Care>>UHC always denies. You should definitely appeal. There are sampleletters in the files section of this group. There have been successfulappeals against UHC, but I think they assume most people won't bother,so they keep the cost lower by r

outinely denying. Just my opinion ofcourse, but I've seen so many UHC denials while in this group.-christinesydney 2 yrs starband grad>> Hi Everyone,> My son Spencer Graduated from his DOC Band in December. For somereason or another, we just got word (via the phone) that United HealthCare has denied our claim to pay for the DOC band. I haven't receivedthe official notice in the mail yet, so I don't know the basis oftheir denial. I've collected some information to help support myclaim. But it would be helpful to look at someone's successful appeal,before I draft mine. One other thing. Would you recommended hiring anattorney to draft the letter and help out with the appeal? > > Thank you for your help> > Lorie>For more plagio info

[Guest guest]

Not sure if you've tried this appraoch yet but we also have United

Healthcare and go Monday for my daughter's casting. I called UHC to

see if they would cover it and they said they do not cover orthotic

helmets at all. Well I work in a very similar field so I knew my

best plan would be to get my husband's Human Resources involved. So

yesterday his HR rep. called UHC and they made an " exception " . So

maybe try getting in touch with your Human Resources and get them

involved.

>

> Hi Everyone,

> My son Spencer Graduated from his DOC Band in December. For

some reason or another, we just got word (via the phone) that United

Health Care has denied our claim to pay for the DOC band. I haven't

received the official notice in the mail yet, so I don't know the

basis of their denial. I've collected some information to help

support my claim. But it would be helpful to look at someone's

successful appeal, before I draft mine. One other thing. Would you

recommended hiring an attorney to draft the letter and help out with

the appeal?

>

> Thank you for your help

>

> Lorie

>

[Guest guest]

We just received our UHC denial yesterday. My dtr was casted on Tues. and will receive her band on Wed. We will go the route of getting HR involved and will also write a letter of appeal if UHC does not budge with HR. Despite the fact the policy says they "do not cover orthotics", they did cover orthotics for my son's shoes to help with a tendon prolapse he got after he broke his leg in football, without any question. I hope they will reconsider their decision and agree to cover the band. Either way, we are going through with banding. Kelli

Re: Need Help with United Health Care

Not sure if you've tried this appraoch yet but we also have United Healthcare and go Monday for my daughter's casting. I called UHC to see if they would cover it and they said they do not cover orthotic helmets at all. Well I work in a very similar field so I knew my best plan would be to get my husband's Human Resources involved. So yesterday his HR rep. called UHC and they made an "exception". So maybe try getting in touch with your Human Resources and get them involved.>> Hi Everyone,> My son Spencer Graduated from his DOC Band in December. For some reason or another, we just got word (via the phone) that United Health Care has denied our claim to pay for the DOC band.

I haven't received the official notice in the mail yet, so I don't know the basis of their denial. I've collected some information to help support my claim. But it would be helpful to look at someone's successful appeal, before I draft mine. One other thing. Would you recommended hiring an attorney to draft the letter and help out with the appeal? > > Thank you for your help> > Lorie>

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