Re: Insurance question - CT vs. Hanger

[Guest guest]

BTW, I have heard of people arguing that the company they went to

was the most experienced/reputable in their area, and/or they were

recommended to go there by their doctor, even though they were out

of network. Unfortunatly, I don't really remember any results from

those appeals/arguments. It seems like a plausible argument to make,

but I just don't know if it would work. Maybe someone else can share

their experience with that though.

Jake-2 (DOCBand Grad 9/08)

Jordan-5

>

> Has anyone ever been able to get an insurance company to reimburse

> treatment costs for an out-of-network company, when the insurance

> company offered an in-network treatment option? We elected to use

an

> out-of-network provider (CT) because we felt more comfortable with

them

> than the in-network provider (Hanger).

>

> Our Pediatrician pretty much insisted that we go with CT, when she

> diagnosed our son with Plagio. She also insisted that we hurry up

to

> start the treatment before our son's cranial plates begin to fuse

(he

> was at 4 months old at the time that we were presented with this

dilema

> of CT vs. Hanger). In the short amount of time that we had to

complete

> our research, it became apparent to us that CT had more experience

and

> also had easily obtainable quantitative data to support the

success of

> their treatment plan. No so much with Hanger. We ended up going

with

> CT, and have been extremely pleased with the results (his helmet

came

> off in 8 weeks, and all measurements are within 1 standard

deviation -

> YEA!!!).

>

> So, has anyone had any success in getting reimbursement when they

chose

> an out-of-network option instead of the in-network provider?

>

> Thanks,

>

> Tom

>

[Guest guest]

We were one of the ones who tried to appleal based on out of network denial. It didn't work in our case, but I'm glad we did it anyway. Good luck!

Plagiocephaly From: nwilkens2275@...Date: Mon, 16 Feb 2009 20:09:45 +0000Subject: Re: Insurance question - CT vs. Hanger

BTW, I have heard of people arguing that the company they went to was the most experienced/reputable in their area, and/or they were recommended to go there by their doctor, even though they were out of network. Unfortunatly, I don't really remember any results from those appeals/arguments. It seems like a plausible argument to make, but I just don't know if it would work. Maybe someone else can share their experience with that though.Jake-2 (DOCBand Grad 9/08)Jordan-5>> Has anyone ever been able to get an insurance company to reimburse > treatment costs for an out-of-network company, when the insurance > company offered an in-network treatment option? We elected to use an > out-of-network provider (CT) because we felt more comfortable with them > than the in-network provider (Hanger). > > Our Pediatrician pretty much insisted that we go with CT, when she > diagnosed our son with Plagio. She also insisted that we hurry up to > start the treatment before our son's cranial plates begin to fuse (he > was at 4 months old at the time that we were presented with this dilema > of CT vs. Hanger). In the short amount of time that we had to complete > our research, it became apparent to us that CT had more experience and > also had easily obtainable quantitative data to support the success of > their treatment plan. No so much with Hanger. We ended up going with > CT, and have been extremely pleased with the results (his helmet came > off in 8 weeks, and all measurements are within 1 standard deviation - > YEA!!!). > > So, has anyone had any success in getting reimbursement when they chose > an out-of-network option instead of the in-network provider? > > Thanks, > > Tom>

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