has an appt

[Guest guest]

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