Re: Question on Insurance Coverage...

[Guest guest]

Mark- It is my understanding from talking to the folks at Cranial

Technologies that United Healthcare is the worst about covering the DOC

band. You should appeal the denial in writing right away so you are within

the timeline required and obtain letters and documentation from your doctors

in support of the medical necessity of the band. Depending on whether you

have private or public health insurance, there are rules that govern your

coverage and depending on your state, laws that apply. Ask the folks at

Cranial Technologies to help you with the appeal, at least here in Phoenix,

they are real advocates for the patients with the insurance companies. We

were able to get Blue Cross to cover the DOC band for our daughter. I can

give you lots more information, but I actually am going out of town, so I

can write later. I am an attorney who practices healthcare law in the

public sector. OUr firms experience has been that United Healthcare has

drawn a random line on how severe a child must be to be covered for the DOC

band and this policy is not based on any medical reason. So Remember to

APPEAL,APPEAL, APPEAL and ask for help from Cranial Technologies and your

pediatrician and neurosurgeon.

-----Original Message-----

From: Mark [mailto:mhennemann@...]

Sent: Wednesday, March 08, 2000 9:44 PM

Plagiocephalyonelist

Subject: Question on Insurance Coverage...

From: " Mark " <mhennemann@...>

Hello,

My son Mason, 6 months old was just diagnosed today. We were

referred to a specialist and had our visit. The doctor referred us

to a local clinic to have a DOC band made. Our insurance company

" United Healthcare " has DENIED all coverage for this. Has anyone had

any luck with their insurance companies paying for the DOC Bands?

Any insight would be helpful..

Mark

------------------------------------------------------------------------

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[Guest guest]

Wow, Tami! When you speak up, you have a lot to good things to share. I'm

really happy you're able to help!

C.

____________________Reply Separator____________________

Subject: RE: Question on Insurance Coverage...

Author: Plagiocephalyonelist

Date: 3/9/00 12:03 AM

From: " Tami " <tjohnson@...>

Mark- It is my understanding from talking to the folks at Cranial

Technologies that United Healthcare is the worst about covering the DOC

band. You should appeal the denial in writing right away so you are within

the timeline required and obtain letters and documentation from your doctors

in support of the medical necessity of the band. Depending on whether you

have private or public health insurance, there are rules that govern your

coverage and depending on your state, laws that apply. Ask the folks at

Cranial Technologies to help you with the appeal, at least here in Phoenix,

they are real advocates for the patients with the insurance companies. We

were able to get Blue Cross to cover the DOC band for our daughter. I can

give you lots more information, but I actually am going out of town, so I

can write later. I am an attorney who practices healthcare law in the

public sector. OUr firms experience has been that United Healthcare has

drawn a random line on how severe a child must be to be covered for the DOC

band and this policy is not based on any medical reason. So Remember to

APPEAL,APPEAL, APPEAL and ask for help from Cranial Technologies and your

pediatrician and neurosurgeon.

-----Original Message-----

From: Mark [mailto:mhennemann@...]

Sent: Wednesday, March 08, 2000 9:44 PM

Plagiocephalyonelist

Subject: Question on Insurance Coverage...

From: " Mark " <mhennemann@...>

Hello,

My son Mason, 6 months old was just diagnosed today. We were

referred to a specialist and had our visit. The doctor referred us

to a local clinic to have a DOC band made. Our insurance company

" United Healthcare " has DENIED all coverage for this. Has anyone had

any luck with their insurance companies paying for the DOC Bands?

Any insight would be helpful..

Mark

------------------------------------------------------------------------

GET A NEXTCARD VISA, in 30 seconds! Get rates as low as 0.0%

Intro or 9.9% Fixed APR and no hidden fees. Apply NOW!

1/937/2/_/689409/_/952577016/

------------------------------------------------------------------------

------------------------------------------------------------------------

PERFORM CPR ON YOUR APR!

Get a NextCard Visa, in 30 seconds! Get rates as low as

0.0% Intro or 9.9% Fixed APR and no hidden fees.

Apply NOW!

1/2121/2/_/689409/_/952581894/

------------------------------------------------------------------------

[Guest guest]

Mark, As far as insurance goes, we are lucky enough the helmet is being

covered at 100%. I made phone calls even before he was fitted for it. They

said it must be med nec. I passed this info to Drs office and he took care of

it. It must have been coded as needed. Stay on good terms w/ Drs let them

know your situation w/ ins co. They may be willing to back you up. Belinda