Re: Insurance denial-Read this!

[Guest guest]

> I asked for a verbal review on the denial for Hannah's DOC band. I

> called the Critical Inquiry Dept. today and talked to a lady there

> who told me that Humana (our insurance company)does not pay for any

> DOC band after 1998 unless following surgery. I told her that I

know

> for a fact that they have paid for at least 2 bands at 100 percent

in

> 2000 and 2001. She told me I would have to prove that by giving

her

> the names of the person. I told her I would not, due to the

> protection of that person. She said that house bill 335 protects

> them.....it states that they can not rescend on a paid claim for

any

> reason. I think it is all a scam. She has to have record of all

> paid claims after 1998 but she wants me to give her names. I told

> her I was willing to hire an attorney or get media attention on

this

> matter. Her response was: it will only HURT your efforts to get

> this paid. Can you believe this. So, now I have to find anyone

who

> has Humana and has gotten them to pay after 1998. I called RDA

where

> we got Hannah's band and they said they had a child whos band was

> paid by Humana just a couple of months ago. They could not release

> there names but I asked them to please contact them and see if I

> could turn in their name as a paid claim. I am about to pull my

hair

> out over this mess. I hope everyone else is having a better time

> with the insurance companies.

>

> Is there anyone out there who has Humana and gotten them to pay

after

> 1998 for their childs DOC band? Any help would be appreciated more

> than you know.

>

> Stacey

,

Does your health plan summary actually state that they don't pay for

headbands? What state are you from? Maybe just get a notarized

statement in writing from your headband clinic saying that Humana has

paid for headbands for some of their patients, forget using names,

and leave it at that. Then keep fighting it through the process and

take it to a state agency after this is exhausted. Humana has

already shot itself in the foot. Good luck.

Dawn