UHC Payment being made

[Guest guest]

Hi Everyone. I rarely post because my son was only in his helmet for

6 weeks and we didn't have any problems with it. I have still been

watchin everyone elses posts.

I received an interesting letter in the mail from UHC. My son has

been out of his helmet for some time now. He received it in March

and only wore it for 6 weeks. I have not submitted an appeal yet. I

was getting ready to start everything needed for it next week. The

only thing I had done was to get my son pediatrician to talk directly

with the UHC one.

Here is the letter...and remember I had not appealed yet....

" We reviewed the appeal filed on your behalf regarding coverage of

the above service that Bradley received from Hanger Orthopedic

Group. We understand the appeal to state that the service rendered

by Hanger Orthopedic Group should be considered under the plan

because the service was medically necessary. During our review, we

considered all the supporting information we have received to date.

The plan under which you are covered is self-funded Group Employee

Welfare Benefit Plan by ERISA. This plan is not subject to state

insurance law. United Healthcare provides administrative and claim

payment services to the plan. United Healthcare is not the insurer

of the plan.

We make decisions about claims payments for medical care based on

your Summary Plan Description and any information we receive as part

of an appeal. Coverage is subject to the exclusions, limitations,

and other terms of your Summary Plan Description.

Based on the information reviewed, we are pleased to inform you that

we have reconsidered these charges as an error was made in the

original processing. Your provider will receive payment within seven

to fourteen business days.....

Vicki S.

Appeals Coordinator "

So I left out another two paragraphs, but I thouht any of you UHC

patients might be interested in this. I have no idea what happened

for UHC to change their mind.