United Healthcare Appeal Success

[Guest guest]

Hi,

I saw the post asking if there was any success in appealing United Healthcare.

I was successful!!! This is the actual process I went through- feel free to

e-mail me if you have more in depth questions:

1. Initial request for coverage denied

2. Appealed (you don't need to worry about providing much documentation here)

3. Second Appeal was denied and this time I sent tons of documents, letters, the

whole sh'bang.

4. Now after two denied appeals- this is when you can appeal your policy to your

human resource department. I advise you keep them in the loop the entire time,

so they aren't shocked by your appeal and have some sympathy on what's going on.

Some departments are allowed to rewrite the policy to take out the exlusion on

cranial bands. (I knew my department could do this and she advised me upfront to

appeal twice with United Healthcare and then to them- she sord of said this

under the table- but she knew I was emotionally so stressed so I think she let

it slip. She never mentioned it again though so I had to have some faith she

was going to hold her end of the deal at the end- an entire year later

actually.) If yours is one of them, then you can appeal but if they don't

actually have the ability to make changes to your insurance policy then I am not

sure you could be successful? So send the human resource department everything

you have sent the insurance company and then write a 3rd letter of appeal to

your Health Plan Administrator. We won this one and within a week of sumbitting

it we finally had a nice check in the mail from United Healthcare with no

problems. We weren't allowed to appeal to the Health Plan Admin until we were

formally denied twice by United Healthcare. It was a lengthy process- but well

worth it.

Hope this helps!

nat.jo.c@...