Guest guest Posted March 1, 2002 Report Share Posted March 1, 2002 My daughter was just diagnosed with positional plagiocephaly 2 weeks ago. I have referrals from my pediatrician for her to receive a DOC Band. I found out today that my insurance is trying to get out of paying. My policy covers medical supplies and equipment as well as orthotics. There are no places in-network. If anyone has suggestions, I'd love to hear them. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 1, 2002 Report Share Posted March 1, 2002 Hello and welcome to the group. Sorry to hear about the potential trouble you are facing with United Healthcare. I know that UHC has paid for the band in some instances and hasn't in other. What would really help your case is a letter of medical necessity from your specialist and any other medical professional that your child has seen. This will help you prove the medical necessity of the band as that is often the cause of the denial. As for the out-of-network - UHC CAN authorize you to use an out-of-network provider if no in-network providers are available so you should definitely check into that. My best advice is to keep notes and copies of absolutely EVERYTHING involving the treatment. Keep phone logs of everyone you talk to regarding the treatment with names, times and summaries. You may need the documentation if you have to write an appeal. Once you have the denial (if you do indeed get denied) you should go through the appeals process and that should be outlined in your policy booklet - if it's not then call your insurance co and ask them to send you the appeals procedures. Good luck and let us know how it goes! Marci (Mom to ) Oklahoma Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.