Re: Insurance denial-Read this!-Dawn

[Guest guest]

Dawn:

Thanks for the advice on the notorized statement from RDA proving

they have received payment from Humana.....I was wondering how to get

around the mess of giving names...Thanks so much.]

Stacey

> > 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