Appealing United Healthcare (hopefully helpful)

[Guest guest]

Typically the first appeal is more automatic if that makes sense. They don't

really look into it. You need to appeal it one more time, which will be your

final time. Two appeals allowed. That one they will review everything. I had

to do this as well but it was denied due to an exclusion on cranial bands. So

my THIRD appeal was not with the United Healthcare but with my human resource

department (plan administrator) to appeal the exclusion in our policy. Within

two days of receiving the appeal (I included the previous insurance appeals)

they had taken out the exclusion and the insurance then accepted it with no

problem. In the meantime I had already started treatment and by the time all

the appealing was done and the reimbursment was made, we were completely done

with our DOC Band and had been for several months. It was a little lengthy but

well worth it. Some policies can be changed like ours were and some cannot.

Depends on the policy, so it may be smart to ask your plan administrator that

before hand. Keep trying though! Good luck.

I don't have all the answers but have been there, so anyone is more than welcome

to e-mail me as I don't get on this site very much.

[Guest guest]

, thanks so much for posting this. I'm sure it will help some folks. It's

always good to hear a success story as well!

>

> Typically the first appeal is more automatic if that makes sense. They don't

really look into it. You need to appeal it one more time, which will be your

final time. Two appeals allowed. That one they will review everything. I had

to do this as well but it was denied due to an exclusion on cranial bands. So

my THIRD appeal was not with the United Healthcare but with my human resource

department (plan administrator) to appeal the exclusion in our policy. Within

two days of receiving the appeal (I included the previous insurance appeals)

they had taken out the exclusion and the insurance then accepted it with no

problem. In the meantime I had already started treatment and by the time all

the appealing was done and the reimbursment was made, we were completely done

with our DOC Band and had been for several months. It was a little lengthy but

well worth it. Some policies can be changed like ours were and some cannot.

Depends on the policy, so it may be smart to ask your plan administrator that

before hand. Keep trying though! Good luck.

> I don't have all the answers but have been there, so anyone is more than

welcome to e-mail me as I don't get on this site very much.

>

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