Help!!! United Healthcare Denial

[Guest guest]

We received a denial from United Healthcare. It indicates " orthotic

appliances that straighten or re-shape a body (including some sorts of

braces) " are excluded from coverage.

Has any one had success in the appeals process with United Healthcare

for this specific denial? Any help you could offer would be most

appreciated.

Thanks,

Jeff

Father to

8 months old

[Guest guest]

Jeff,

Sorry to see you were denied. We too were denied. Before we even

received our denia; letter, we had our 7 month old son banded. We went

ahead with it because we did not want to lose precious time. We will

bw appealing too. If you can afford the cost upfront, just go ahead

and get the process started. If UHC will cover it, they should

reimburse your portion back. If they still deny it, at least you

started.

If anyone finds a loop hole with UHC, please let us know. It is just

so frustrating that they claim the band re-shapes. It really doesn't,

it allows for growth.

Good luck!

Jenn

>

> We received a denial from United Healthcare. It indicates " orthotic

> appliances that straighten or re-shape a body (including some sorts

of

> braces) " are excluded from coverage.

>

> Has any one had success in the appeals process with United Healthcare

> for this specific denial? Any help you could offer would be most

> appreciated.

>

> Thanks,

>

> Jeff

> Father to

> 8 months old

>

[Guest guest]

We haven't filed our formal appeal yet. My employer is self insured,

and United Healthcare is only the administrator of our insurance. I

went to the head of our benefits department to see what she

recommended we do, as in the end it is my employer that " pays " the

bill. It has been a little over week, and I have't heard back yet.

We already went ahead and paid for the band. He has been in it 3

weeks now. Things are going well.

If anyone has any suggestions on how to get this paid please let us

know.

Thx,

Jeff

> >

> > We received a denial from United Healthcare. It

indicates " orthotic

> > appliances that straighten or re-shape a body (including some

sorts

> of

> > braces) " are excluded from coverage.

> >

> > Has any one had success in the appeals process with United

Healthcare

> > for this specific denial? Any help you could offer would be most

> > appreciated.

> >

> > Thanks,

> >

> > Jeff

> > Father to

> > 8 months old

> >

>

[Guest guest]

I have a different insurance and covers 90% but they still need a prescription from my ped. I have an appointment with him today because it looks like he does not want to give us the prescription. Can you believe that? insurance covers but ped doesn't want to give ok. If that's the case I am going to change ped. When I asked the lady (insurance) from CT if we can start the process while we do the insurance paperwork so we don't waste time because we are going to a trip on july and want to finish with the band before that, she said that she has to check with the insurance because sometimes there are penalties for starting the treatment before they give the ok, so you better check before starting. I am waiting but if the penaltie is not to high I probably pay it. jrmcgrath71 <mcgrathjk@...> wrote: We haven't filed our formal appeal yet. My employer is self insured, and United Healthcare is only the administrator of our insurance. I went to the head of our benefits department to see what she recommended we do, as in the end it is my employer that "pays" the bill. It has been a little over week, and I have't heard back yet. We already went ahead and paid for the band. He has been in it 3 weeks now. Things are going well.If anyone has any suggestions on how to get this paid please let us know.Thx,Jeff> >> > We received a denial from United Healthcare. It indicates "orthotic > > appliances that straighten or re-shape a body (including some sorts > of > > braces)" are excluded from coverage.> > > > Has any one had success in the appeals process with United Healthcare > > for this specific denial? Any help you could offer would be most > > appreciated.> > > > Thanks,> > > > Jeff> > Father to > > 8 months old> >>

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