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UCH Denial Letter

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Hi Everyone, (Sorry this is kind of long)

UHC denied Spencer's claim for the DOC band. I just got the letter in the mail today and I am somewhat confused. It states:

"Based on the information provided, This service does not meet coverage requirments as defined in your plan. Therefore, no benefits are payable for this expense. In order for this service to be considered for coverage, you must submit medical recods that demonstrate a physiological functional impairment, along with an requirments indicated in your benefit plan language."

So I check out my benfits package and it looks like they made this determination off of the "Reconstructive Procedures" Section

Any advice? Has anyone else had this kind of denial letter?

Thank you for your help.

Lorie

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