[SPAM]Re: [SPAM] Help!!! United Healthcare Denial

[Guest guest]

Thanks Lorie.

I am sure he will pay his sister back for that!

> >

> > Jeff,

> > I just got back from a meeting with my attorney about this

> issue. I'm not sure which plan you have with UHC,(or what was in

> your first appeal letter) but this is how I was instructed to

draft

> my appeal letter. Under my plan, Durable Medical Equipment is

> covered. A DOC Band classifies as Durable Medical Equipment,

because

> it meets all the criteria for durable medical equipment. A DOC

Band

> is :

> > 1)Ordered or provided by a Physician for outpatient use

> > 2) Used for medical purposes

> > 3) Not consumable or disposable

> > 4) Not of use to a person in the absence of a disease or

> disability

> > " If more than one piece of Durable Medical Equipment can meet

your

> functional needs, Benefits are available for the cost effective

piece

> of equipment. "

> >

> > In regards to the policy exclusion- " braces that straighten or

> change the shape of a body part are orthotic devices. " A DOC band

> corrects the abnormality on a child that most of the time is

caused

> inutro. (My son's plagio was caused by the how he was positioned

> inutro). So the DOC band isn't providing a cosmetic purpose, it

is

> fixing a birth defect (at least this is the case with my son). An

> orthotic device that changes the shape of a body part is more

along

> the lines of dental braces/retainer...

> >

> > Sorry this is a bit long, I hope some of this can help you out.

> >

> >

> > Best of luck

> >

> > Lorie

> > Mom to Spencer and Alizabeth 1 year

> > Spencer- Left Plagio- DOC Band GRAD 9/07-12/07

> > Glendale, AZ

> > [sPAM] Help!!! United Healthcare Denial

> >

> >

> > 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,

Attached is a copy of my appeal letter. I just sent it over to my attorney, so he hasn't looked over it yet. But I thought I would send it to you so you could also get started on your appeal. Once my attorney looks it over and sends it back to me, I will send you an updated copy..

Best of Luck

Lorie

Mom to Spencer and Alizabeth 1 yr

-Spencer- Left Plagio- DOC Band Grad 9/07-12/07

Glendale, Az

[sPAM] Help!!! United Healthcare Denial> > > 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>