Re: United healthcare anyone? Insurance troubles...

[Guest guest]

Hello! Very long story short, yes we have United Healthcare and it has been

trouble from the beginning. We ended up going to Shriner's for casting in SLC

because our insurance would not cover anything with regards to casting. Then

when casting did not work for our son Matson, we had to find a surgeon who could

do Dual Growing Rods. We had to go out of state to San Diego and it was a 9

month process with United Healthcare to get the surgery and all of its

components approved. I had to go in front of the appeals board twice, was denied

and submitted another appeal and the last one was finally approved by a panel.

Now his first surgery was in 2010, and I am still fighting every week with new

bills we get from various doctors, labs hospitals etc for his original surgery

and the 3 lengthening surgeries he has had thus far. IT is a NIGHTMARE! I don't

mean to scare you, but it has been very hard. So my advice is keep a major paper

trail for everything! Get a few contacts at United Healthcare and don't be

afraid to utilize them. Be aggressive, you have insurance and ALL facets of your

childs treatments should fall under their guidelines. I learned this all the

hard way, and would hate for you to have to endure it as well. At one point,

minutes before Matson's surgery I was called by UHC and told anesthesia wouldnt

be covered for his surgery, he could have the surgery but no

anesthesia...utterly ridiculous! We are still fighting that bill and others. So

be prepared for a fight! Hopefully you will find a good contact within UHC and

all things will be taken care of, I just want to warn you so are aware and not

afraid to speak up and demand coverage. Please feel free to contact me if you

would like. mattnsteph4nier@...

I wish you the very best!

Best regards,

Mom to Matson (6) Casting, bracing, Dual Growing Rods

Tyler (9)

Lily (5)

Steph

---- lindsayrineer <lindsayrineer@...> wrote:

> My son is scheduled to get his first cast tomorrow. We got a call from our

nurse today and she said that our insurance was not going to cover the

manipulation of the spine. They even spoke to our dr and denied it again. They

will cover the anesthesia and cast, but not manipulation of the spine. I was so

upset. The nurse said the insurance co requested further medical documents and

that it could take awhile to get an answer.

>

> We decided to pay out of pocket as our son needs to be casted. I'm just

curious if anyone else has dealt with this? It's very frustrating.

>

> By the way, we are going to children's in Birmingham, al. We were also

accepted at Shriners in Philly, but AL is much closer for us.

>

[Guest guest]

Hello! Very long story short, yes we have United Healthcare and it has been

trouble from the beginning. We ended up going to Shriner's for casting in SLC

because our insurance would not cover anything with regards to casting. Then

when casting did not work for our son Matson, we had to find a surgeon who could

do Dual Growing Rods. We had to go out of state to San Diego and it was a 9

month process with United Healthcare to get the surgery and all of its

components approved. I had to go in front of the appeals board twice, was denied

and submitted another appeal and the last one was finally approved by a panel.

Now his first surgery was in 2010, and I am still fighting every week with new

bills we get from various doctors, labs hospitals etc for his original surgery

and the 3 lengthening surgeries he has had thus far. IT is a NIGHTMARE! I don't

mean to scare you, but it has been very hard. So my advice is keep a major paper

trail for everything! Get a few contacts at United Healthcare and don't be

afraid to utilize them. Be aggressive, you have insurance and ALL facets of your

childs treatments should fall under their guidelines. I learned this all the

hard way, and would hate for you to have to endure it as well. At one point,

minutes before Matson's surgery I was called by UHC and told anesthesia wouldnt

be covered for his surgery, he could have the surgery but no

anesthesia...utterly ridiculous! We are still fighting that bill and others. So

be prepared for a fight! Hopefully you will find a good contact within UHC and

all things will be taken care of, I just want to warn you so are aware and not

afraid to speak up and demand coverage. Please feel free to contact me if you

would like. mattnsteph4nier@...

I wish you the very best!

Best regards,

Mom to Matson (6) Casting, bracing, Dual Growing Rods

Tyler (9)

Lily (5)

Steph

---- lindsayrineer <lindsayrineer@...> wrote:

> My son is scheduled to get his first cast tomorrow. We got a call from our

nurse today and she said that our insurance was not going to cover the

manipulation of the spine. They even spoke to our dr and denied it again. They

will cover the anesthesia and cast, but not manipulation of the spine. I was so

upset. The nurse said the insurance co requested further medical documents and

that it could take awhile to get an answer.

>

> We decided to pay out of pocket as our son needs to be casted. I'm just

curious if anyone else has dealt with this? It's very frustrating.

>

> By the way, we are going to children's in Birmingham, al. We were also

accepted at Shriners in Philly, but AL is much closer for us.

>

[Guest guest]

We go to ish Rite Hospital so we haven't had this particular situation b/c they did not charge back when our daughter was put in her casts.  However, we had United Healthcare for one year and our daughter has other issues and it was really awful having that insurance.  We have switched back to my husband's coverage at his work.  So sorry you have to deal with this.  I don't understand why it is so hard to get help for those that really need it.  Praying it works out for you.

On Wed, Mar 7, 2012 at 12:27 PM, <mattnsteph4nier@...> wrote:

Hello! Very long story short, yes we have United Healthcare and it has been trouble from the beginning. We ended up going to Shriner's for casting in SLC because our insurance would not cover anything with regards to casting. Then when casting did not work for our son Matson, we had to find a surgeon who could do Dual Growing Rods. We had to go out of state to San Diego and it was a 9 month process with United Healthcare to get the surgery and all of its components approved. I had to go in front of the appeals board twice, was denied and submitted another appeal and the last one was finally approved by a panel. Now his first surgery was in 2010, and I am still fighting every week with new bills we get from various doctors, labs hospitals etc for his original surgery and the 3 lengthening surgeries he has had thus far. IT is a NIGHTMARE! I don't mean to scare you, but it has been very hard. So my advice is keep a major paper trail for everything! Get a few contacts at United Healthcare and don't be afraid to utilize them. Be aggressive, you have insurance and ALL facets of your childs treatments should fall under their guidelines. I learned this all the hard way, and would hate for you to have to endure it as well. At one point, minutes before Matson's surgery I was called by UHC and told anesthesia wouldnt be covered for his surgery, he could have the surgery but no anesthesia...utterly ridiculous! We are still fighting that bill and others. So be prepared for a fight! Hopefully you will find a good contact within UHC and all things will be taken care of, I just want to warn you so are aware and not afraid to speak up and demand coverage. Please feel free to contact me if you would like.  mattnsteph4nier@...

I wish you the very best!

Best regards,

Mom to Matson (6) Casting, bracing, Dual Growing Rods

Tyler (9)

Lily (5)

Steph

---- lindsayrineer <lindsayrineer@...> wrote:

> My son is scheduled to get his first cast tomorrow. We got a call from our nurse today and she said that our insurance was not going to cover the manipulation of the spine. They even spoke to our dr and denied it again. They will cover the anesthesia and cast, but not manipulation of the spine. I was so upset. The nurse said the insurance co requested further  medical documents and that it could take awhile to get an answer.

>

> We decided to pay out of pocket as our son needs to be casted. I'm just curious if anyone else has dealt with this? It's very frustrating.

>

> By the way, we are going to children's in Birmingham,  al. We were also accepted at Shriners in Philly, but AL is much closer for us.

>

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

[Guest guest]

We go to ish Rite Hospital so we haven't had this particular situation b/c they did not charge back when our daughter was put in her casts.  However, we had United Healthcare for one year and our daughter has other issues and it was really awful having that insurance.  We have switched back to my husband's coverage at his work.  So sorry you have to deal with this.  I don't understand why it is so hard to get help for those that really need it.  Praying it works out for you.

On Wed, Mar 7, 2012 at 12:27 PM, <mattnsteph4nier@...> wrote:

Hello! Very long story short, yes we have United Healthcare and it has been trouble from the beginning. We ended up going to Shriner's for casting in SLC because our insurance would not cover anything with regards to casting. Then when casting did not work for our son Matson, we had to find a surgeon who could do Dual Growing Rods. We had to go out of state to San Diego and it was a 9 month process with United Healthcare to get the surgery and all of its components approved. I had to go in front of the appeals board twice, was denied and submitted another appeal and the last one was finally approved by a panel. Now his first surgery was in 2010, and I am still fighting every week with new bills we get from various doctors, labs hospitals etc for his original surgery and the 3 lengthening surgeries he has had thus far. IT is a NIGHTMARE! I don't mean to scare you, but it has been very hard. So my advice is keep a major paper trail for everything! Get a few contacts at United Healthcare and don't be afraid to utilize them. Be aggressive, you have insurance and ALL facets of your childs treatments should fall under their guidelines. I learned this all the hard way, and would hate for you to have to endure it as well. At one point, minutes before Matson's surgery I was called by UHC and told anesthesia wouldnt be covered for his surgery, he could have the surgery but no anesthesia...utterly ridiculous! We are still fighting that bill and others. So be prepared for a fight! Hopefully you will find a good contact within UHC and all things will be taken care of, I just want to warn you so are aware and not afraid to speak up and demand coverage. Please feel free to contact me if you would like.  mattnsteph4nier@...

I wish you the very best!

Best regards,

Mom to Matson (6) Casting, bracing, Dual Growing Rods

Tyler (9)

Lily (5)

Steph

---- lindsayrineer <lindsayrineer@...> wrote:

> My son is scheduled to get his first cast tomorrow. We got a call from our nurse today and she said that our insurance was not going to cover the manipulation of the spine. They even spoke to our dr and denied it again. They will cover the anesthesia and cast, but not manipulation of the spine. I was so upset. The nurse said the insurance co requested further  medical documents and that it could take awhile to get an answer.

>

> We decided to pay out of pocket as our son needs to be casted. I'm just curious if anyone else has dealt with this? It's very frustrating.

>

> By the way, we are going to children's in Birmingham,  al. We were also accepted at Shriners in Philly, but AL is much closer for us.

>

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

[Guest guest]

Oh that breaks my heart for you! I hate dealing with insurance companies

that just don't get it or are trying to save a buck! I'm sure you will

call call call til it gets figured out! For crying out loud this is why

we have health insurance in the first place!

Amber

> My son is scheduled to get his first cast tomorrow. We got a call from our

> nurse today and she said that our insurance was not going to cover the

> manipulation of the spine. They even spoke to our dr and denied it again.

> They will cover the anesthesia and cast, but not manipulation of the

> spine. I was so upset. The nurse said the insurance co requested further

> medical documents and that it could take awhile to get an answer.

>

> We decided to pay out of pocket as our son needs to be casted. I'm just

> curious if anyone else has dealt with this? It's very frustrating.

>

> By the way, we are going to children's in Birmingham, al. We were also

> accepted at Shriners in Philly, but AL is much closer for us.

>

>

[Guest guest]

Oh that breaks my heart for you! I hate dealing with insurance companies

that just don't get it or are trying to save a buck! I'm sure you will

call call call til it gets figured out! For crying out loud this is why

we have health insurance in the first place!

Amber

> My son is scheduled to get his first cast tomorrow. We got a call from our

> nurse today and she said that our insurance was not going to cover the

> manipulation of the spine. They even spoke to our dr and denied it again.

> They will cover the anesthesia and cast, but not manipulation of the

> spine. I was so upset. The nurse said the insurance co requested further

> medical documents and that it could take awhile to get an answer.

>

> We decided to pay out of pocket as our son needs to be casted. I'm just

> curious if anyone else has dealt with this? It's very frustrating.

>

> By the way, we are going to children's in Birmingham, al. We were also

> accepted at Shriners in Philly, but AL is much closer for us.

>

>

[Guest guest]

So sorry about this. I know there are a lot of families that have had issues with insurance. I live in Canada so its a bit different . Our casting is all covered but braces and things arnt. Because my son is on a special government program he does get some stuff paid for but its all how the paper is filled out and what you choose to call.some things. i know some people has issues because.it spine.manipulations so their Dr/ hospital said it was just a risser cast and it was covered. Might be worth a shot. Maybe some of those parents will chime in.Good luck Sent from Samsung Mobile

Amber Scholl wrote:

Oh that breaks my heart for you! I hate dealing with insurance companies

that just don't get it or are trying to save a buck! I'm sure you will

call call call til it gets figured out! For crying out loud this is why

we have health insurance in the first place!

Amber

> My son is scheduled to get his first cast tomorrow. We got a call from our

> nurse today and she said that our insurance was not going to cover the

> manipulation of the spine. They even spoke to our dr and denied it again.

> They will cover the anesthesia and cast, but not manipulation of the

> spine. I was so upset. The nurse said the insurance co requested further

> medical documents and that it could take awhile to get an answer.

>

> We decided to pay out of pocket as our son needs to be casted. I'm just

> curious if anyone else has dealt with this? It's very frustrating.

>

> By the way, we are going to children's in Birmingham, al. We were also

> accepted at Shriners in Philly, but AL is much closer for us.

>

>

[Guest guest]

OK guys I have united health care and never had a problem. You need to use these billing codes: 

We use 29010 for the casting with diagnosis 737.32

That is the only way to do it.  

Jenn 

[Guest guest]

One more thing.  I go to Rochester and See dr. S.  I specifically asked him for those codes for other families.  The insurance has never once blinked.  email me if you have questions I can pull out old bills. 

jenn 

[Guest guest]

Thise codes are good to have on hand, thanks Jenn! Also, because our policy is an HMO, things are much harder than if the coverage is a PPO or other type of plan. All this stuff I never knew before! FournierSent from my iPhoneOn Mar 7, 2012, at 11:28 AM, Leggett <jennifer.leggett@...> wrote:

One more thing. I go to Rochester and See dr. S. I specifically asked him for those codes for other families. The insurance has never once blinked. email me if you have questions I can pull out old bills.

jenn

[Guest guest]

Unacceptable! How frustrating! We hope to have ET Mehta casting accepted

as standard of care and reimbursed by ins. companies by 2013. Its a long

process, but the ball is now rolling. I'll keep everyone posted on this.

HRH

> My son is scheduled to get his first cast tomorrow. We got a call from our

> nurse today and she said that our insurance was not going to cover the

> manipulation of the spine. They even spoke to our dr and denied it again.

> They will cover the anesthesia and cast, but not manipulation of the

> spine. I was so upset. The nurse said the insurance co requested further

> medical documents and that it could take awhile to get an answer.

>

> We decided to pay out of pocket as our son needs to be casted. I'm just

> curious if anyone else has dealt with this? It's very frustrating.

>

> By the way, we are going to children's in Birmingham, al. We were also

> accepted at Shriners in Philly, but AL is much closer for us.

>

>