Re: We're getting casted tomorrow!

[Guest guest]

:

That's terrific news about your ins. coming thru for you! Like you

said, either $600 or $900 for your co payment, isn't bad at all!

Especially w/no fighting like so many members have to do.

Best of luck tomorrow at the casting! It'll be over quickly, try not

to stress too much about it.

Please let us know how it goes....thanks for the good update!

Debbie Abby's mom DOCGrad

MI

> Hi all,

>

> It's been awhile since I've posted but I've read most posts everyday

> just trying to keep up with what's going on with everybody. Last

time I

> posted was when we found out that CCN/Mountain States Administrative

> Services denied the coverage of the Docband for Mackenzie.

Actually, I

> guess I should say that it was the Precertification Dept/Managed

Care

> that denied us. We found out that CCN will probably be overriding

the

> denial based on the appeal that we sent in. However, even if they

don't

> override the appeal, CCN will still be paying 70% of the cost of the

> band! I'm not sure exactly how this all works but if you don't

follow

> the precert procedure the benefit is only reduced by 10% so instead

of

> 80% paid, they will definitely pay the 70%! This is even stated in

our

> benefits booklet! I guess another baby just went through this with

CCN

> and successfully won their appeal so our representative is now

familiar

> with the band, the diagnosis that accompanies it and how it actually

> works! So, we'll either be paying $600 or $900 depending on the

outcome

> of the appeal. Our rep definitely said not to wait to get the appeal

> approval especially since Mackenzie is almost 10 months old but to

go

> ahead and do the casting and bill CCN. CT here in Phoenix will just

put

> us on the payment plan and we'll pay the $600 tomorrow and pay the

> remaining $300 when/if it gets billed to us. I don't know how we

got so

> lucky in having this particular insurance company but let me tell

you,

> I'm thrilled we do especially after reading all of the trouble that

most

> people have!

>

> Now starts the process of the casting & fittings! I am definitely

not

> looking forward to tomorrow as Mackenzie does not like to be held

down

> for just diaper changes, much less a casting of her head! But my

> husband, , is taking time of off work so that he can be there

with

> us for which I'm really glad. I'm going to follow all of the

suggestions

> that I've found here and hopefully, it will just be over as soon as

> possible. I will let you all know how it goes and I will post pics

of

> Mackenzie with the band once it arrives.

>

> Thank you all for so much information and support through the

postings

> on this board!

>

> (mom to Mackenzie)

> Phoenix, AZ