Re: Insurance denial-Please Help!

[Guest guest]

I know that this comes up a lot here, and the answer is, an exclusion is an exclusion. It is one of those things writted in your plan that can't be changed. I am sorry you are going through this, but from reading on here I dont think anyone received approval for an exclusion.

Katrin

Elijah 6 months banded 2/21/08

Insurance denial-Please Help!

My son is now 8 & 1/2 months old and I just received

my second denial letter from United Health Care, this

one in response to my first appeal letter. My appeal

letter was a 12 page document which included

explanation of medical necessity, current standards of

care in treating plagio/brachy, AMA definitions of

deformities, disfigurement, and congenital defects,

and cosmetic vs. reconstructive, extensive research of

long term effects of untreated plagio, etc. I am so

upset and I don't know what else to do. I spent so

much time and energy in my first appeal letter and I

feel like my window of opportunity is slipping by.

Does anyone else have any suggestions for me? Should

I attempt a second appeal letter? If so, what else

can I include to convince them? The reason they gave

me for denial is plan exclusion based on the helmet

being an orthotic appliance that straightens or

re-shapes a body part. Thank you in advance for any

help. I am desperate.

Cincinnati, OH

__________________________________________________________

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[Guest guest]

Were you given the same reason for denial in your first denial from them? They CAN NOT deny for two completely separate reasons. Also, check your plan. I've had my insurance company mess mine up SEVERAL times.

Insurance denial-Please Help!

My son is now 8 & 1/2 months old and I just receivedmy second denial letter from United Health Care, thisone in response to my first appeal letter. My appealletter was a 12 page document which includedexplanation of medical necessity, current standards ofcare in treating plagio/brachy, AMA definitions ofdeformities, disfigurement, and congenital defects,and cosmetic vs. reconstructive, extensive research oflong term effects of untreated plagio, etc. I am soupset and I don't know what else to do. I spent somuch time and energy in my first appeal letter and Ifeel like my window of opportunity is slipping by. Does anyone else have any suggestions for me? ShouldI attempt a second appeal letter? If so, what elsecan I include to convince them? The reason they gaveme for denial is plan exclusion based on the helmetbeing an orthotic appliance that straightens orre-shapes a body part.

Thank you in advance for anyhelp. I am desperate. Cincinnati, OH____________ _________ _________ _________ _________ _________ _Be a better friend, newshound, and know-it-all with Mobile. Try it now. http://mobile. / ;_ylt=Ahu06i62sR 8HDtDypao8Wcj9tA cJ

Be a better friend, newshound, and know-it-all with Mobile. Try it now.