any successful appeal to UHC for exclusion? (moderate plagiocephaly)

June 3, 2009

My son was denied coverage when we filed a preliminary request for coverage due

to exclusion from our policy. The reason they gave was that any orthotic that

is used to shape or reshape a body part will not be covered.

I have seen a lot of successful appeal letters on this site, but are there any

that succeeded with a case of moderate plagiocephaly? My son has an asymmetry

of 9mm, just under the 10mm that appears to be required to be deemed as severe,

according to a UHC bulleting of March 2008.

oviderStaticFiles/ProviderStaticFilesPdf/Tools%20and%20Resources/Network%20Bulle\

tin/Network%20Bulletin_MARCH%202008%20FINAL.pdf

Much thanks in advance.

June 3, 2009

hi i am so sorry hey didnt cover the band...tell the facility you are going to

to measure again!!! that sucks they can say its 10 mm and try to go through the

insurance again.

my sons freaking medicaid covered his STARband. maybe that is a good

arguement....say its pathetic that a family whos children are on medicaid gets

covered but that you ahve actually been paying and when you need something they

deny and argue you will find another insurance company...

i hope this is what you were asking....sorry i dont know alot but good luck.

>

> My son was denied coverage when we filed a preliminary request for coverage

due to exclusion from our policy. The reason they gave was that any orthotic

that is used to shape or reshape a body part will not be covered.

>

> I have seen a lot of successful appeal letters on this site, but are there any

that succeeded with a case of moderate plagiocephaly? My son has an asymmetry

of 9mm, just under the 10mm that appears to be required to be deemed as severe,

according to a UHC bulleting of March 2008.

>

oviderStaticFiles/ProviderStaticFilesPdf/Tools%20and%20Resources/Network%20Bulle\

tin/Network%20Bulletin_MARCH%202008%20FINAL.pdf

>

> Much thanks in advance.

>

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