Re: Time to appeal.....Principal Insurance! All help appreciated! (V...

[Guest guest]

,

Well, it really sounds like you did all that you should and could do for your

first submission. I would suggest checking out the " bookmarks " section at our

homepage and see if you can find some links to some articles that might help.

Point to the fact that a SPECIALIST believes the band to be medically

necessary and if the specialist is " in-network " you can point out that a

specialist IN THEIR VERY OWN NETWORK finds the band to be medically

necessary. You might also point out that you are not going away and that you

itend to push this as far as necessary. The first appeal level is usually a

written appeal. The second level is often face to face with a " panel " and

then if you lose that appeal you can ask for an external review board to hear

your case. That is ultimately where I ended up (external review board) and

they are the ones who reversed the decision. They wrote an outstanding letter

which actually referred to some federal legislation.

Good luck and keep after them!!

Marci (Mom to )

Oklahoma