Guest guest Posted July 18, 2002 Report Share Posted July 18, 2002 , You sound so much more at peace with the situation at hand right now, good for you!!! I really hope that Guardian comes through for you and picks up the whole tab, but like you said, whatever they pay is better than nothing! Good luck with the casting, keep us posted as it gets closer! Niki Kaylie & Danny (STAR grads) Phila., PA > I made an appt for for the casting and to pick up the helmet. So now > at least that is done. He is going August 1st for the casting and August > 15th he gets the helmet. > > We have decided to go with Guardian (since our insurance is changing August > 1st) instead of Anthem (which already denied the claim). I think we will > have a better chance with Guardian and we would have more leverage with > them..since they will be covering us from now on. > > When Wanda called them (which Wanda has definitely been more helpful and > nice) to verify if they will cover the band...they told her that it is based > on medical necessity and that preauthorization isn't required. So basically > when they send the claim in (with my letter of medical necessity) they will > let us know then whether it is covered. So we are going to have to pay it > upfront..and then send the claim in..and if they deny it..we will appeal. I > have a good feelign though that they might pay some of it....i'm trying to > stay positive.. > > But Wanda told me that the insurance is out of network..so we have a $500 > deductible...and then they pay 70% of what they feel is reasonable..so if > they only think $2000 is reasonable instead of $3000 then i owe the rest..but > i know that whatever they pay is better than nothing... > > I'm just anxious to get started...even though i know i'm going to have a > tough time at the casting and with the whole helmet thing..but i'll try to > make it as positive as i can... > > Well thanks for listening!! > > > Mom to Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 18, 2002 Report Share Posted July 18, 2002 : Great! Glad you have your appts scheduled, now you can sit at home & worry about the casting for the next 2 wks! That's what I did, I drove dh so crazy! I found the actual casting wasn't nearly as bad as I had worried about, it wasn't great, but Abby got over it quickly, a lot faster than I did! LOL. I'll keep my fingers crossed ins. will come thru. It definitely sounds like you have a much better chance of your new ins. covering than your previous. Things sound like they're working out just great for you! Keep us posted....stop biting your nails worrying about the casting in the meantime! Abby's been thru 4 and she's no worse off today for it! Debbie Abby's mom DOCGrad MI > I made an appt for for the casting and to pick up the helmet. So now > at least that is done. He is going August 1st for the casting and August > 15th he gets the helmet. > > We have decided to go with Guardian (since our insurance is changing August > 1st) instead of Anthem (which already denied the claim). I think we will > have a better chance with Guardian and we would have more leverage with > them..since they will be covering us from now on. > > When Wanda called them (which Wanda has definitely been more helpful and > nice) to verify if they will cover the band...they told her that it is based > on medical necessity and that preauthorization isn't required. So basically > when they send the claim in (with my letter of medical necessity) they will > let us know then whether it is covered. So we are going to have to pay it > upfront..and then send the claim in..and if they deny it..we will appeal. I > have a good feelign though that they might pay some of it....i'm trying to > stay positive.. > > But Wanda told me that the insurance is out of network..so we have a $500 > deductible...and then they pay 70% of what they feel is reasonable..so if > they only think $2000 is reasonable instead of $3000 then i owe the rest..but > i know that whatever they pay is better than nothing... > > I'm just anxious to get started...even though i know i'm going to have a > tough time at the casting and with the whole helmet thing..but i'll try to > make it as positive as i can... > > Well thanks for listening!! > > > Mom to Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 18, 2002 Report Share Posted July 18, 2002 NATALIE!!! We go to get casted on August 1st too!! Our appt is 10:45. I am nervous but excited! When is your appt? -/Logan 5 months PA > I made an appt for for the casting and to pick up the helmet. So now > at least that is done. He is going August 1st for the casting and August > 15th he gets the helmet. > > We have decided to go with Guardian (since our insurance is changing August > 1st) instead of Anthem (which already denied the claim). I think we will > have a better chance with Guardian and we would have more leverage with > them..since they will be covering us from now on. > > When Wanda called them (which Wanda has definitely been more helpful and > nice) to verify if they will cover the band...they told her that it is based > on medical necessity and that preauthorization isn't required. So basically > when they send the claim in (with my letter of medical necessity) they will > let us know then whether it is covered. So we are going to have to pay it > upfront..and then send the claim in..and if they deny it..we will appeal. I > have a good feelign though that they might pay some of it....i'm trying to > stay positive.. > > But Wanda told me that the insurance is out of network..so we have a $500 > deductible...and then they pay 70% of what they feel is reasonable..so if > they only think $2000 is reasonable instead of $3000 then i owe the rest..but > i know that whatever they pay is better than nothing... > > I'm just anxious to get started...even though i know i'm going to have a > tough time at the casting and with the whole helmet thing..but i'll try to > make it as positive as i can... > > Well thanks for listening!! > > > Mom to Quote Link to comment Share on other sites More sharing options...
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