Re: in-network appeal

[Guest guest]

I have no idea how they could possibly deny your appeal. Seriously,

a 4-state area???!! It seems so obvious! What a great argument.

Our 'option' wasn't listed in our handbook either, it took some

research by our insurance 'care management' people (one step above

regular cust service, ha ha, right) to find it. Our ped didn't even

know it existed, and he's really aware of plagio, dx'd emma's tort at

8 weeks. So I thought I had a clear argument too, then they came

back with this crazy thing!

Maybe if we all keep pushing for in-network coverage, it will become

standard & so much easier for everyone else down the road. I don't

see this going away anytime soon.

Again, GOOD LUCK!!!

--- In Plagiocephaly , " laura gill " <mamagill@h...>

wrote:

> We have no one who is considered in network so aside from saying

i'm asking

> for in network coverage for these reasons, it's not like i need to

compare

> it to, or fight it against another company. I literally have no

cranio

> person in network in VA, MD, DC, or WV. So it's like, ugh, what do

i say???

> So i think i'm going to say something about how we were

recommended there,

> after numerous phone calls to insurance no one could provide us

with info on

> an in network provider, nor is there one listed in their physicians

> handbook. Therefore we had no choice but to commit ou tof network

with

> cranial tech, nor did we have time to search any longer considering

my sons

> age at the time.

>

> Thanks for your info and i'd love to hear your appeal!

>

>

> Ashburn, VA

>

> >From: " eclarebear " <sarah@p...>

> >Reply-Plagiocephaly

> >Plagiocephaly

> >Subject: Re: in-network appeal

> >Date: Tue, 14 Dec 2004 23:58:40 -0000

> >

> >

> >Hi -

> >

> >I have no help to offer, just wanted to let you know that i'm doing

> >the same thing...(see my post from yesterday) If you can believe

it,

> >our in-network " option " isn't even FDA approved! I'm modeling my

> >letter after the appeal ones, but just arguing that our in-network

> >alternative is not a real alternative. My ped is writing a letter

> >too, stating why he referred us to the DOC, so hopefully this will

> >work.

> >

> >Best of luck, I'll be cheering for you!

> >

> >, mom to Emma, 6 mo.

> >tort/plagio/docBand 10/25

> >Cleveland, OH

> >

> >

> >--- In Plagiocephaly , " " <mamagill@h...>

wrote:

> > >

> > > Has anyone ever appealed only for in-network coverage? I'm

> > > searching for a sample letter and cannot find one. (Oh no, i

might

> > > actually have to write one on my own!) My first appeal was

> >approved

> > > and we've been allowed 1k for DME out of network but i'm going

to

> > > appeal again for entire coverage.

> > >

> > > Any assistance will be helpful!

> > >

> > > Thanks,

> > > & , 9 months (Doc Band 11/17, brachy/mild tort)

> > > Ashburn, VA

> >

> >

> >

>

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