RE: [SPAM] Definity/United Healthcare paid for our helmet! don't give up!

[Guest guest]

I really haven’t posted since joining (sorry, but I recently

had to go back to work and have been so stressed about it and busy), but wanted

to chime in.  Will (almost 6 months) is getting his Starband on Friday.  We

have UHC and were just told that they ARE covering it.  I had gone ahead and

ordered it out-of-pocket so we wouldn’t have to keep waiting.  Now I will

work on reimbursement.  I was surprised they allowed it (just because they are

known to deny all the time).  I think maybe it helped that we had documentation

of doctor visits at 2 months of age and again at 4 1/2  months showing that

conservative treatment didn’t work.  We went to a pediatric neurosurgeon

as our specialist.  His letter of medical necessity had references to articles

showing the need and was very strongly worded.  We are hoping that he will

adjust well and I, like others, am scared for the nighttime!  He is an easy

going baby and I hope that helps him adjust.  I will post pictures when I can. 

Thanks!

Cheri

Mom to Will (6 months on Dec. 9th ) getting his

Starband Friday! 

9mm plagiocephaly, right ear asymmetry and left facial asymmetry

(don’t know all the numbers!)

Also mom to Maggie (2 years old) and (5 ½ years old)

From:

Plagiocephaly [mailto:Plagiocephaly ] On

Behalf Of allymonkey

Sent: Tuesday, December 02, 2008 10:25 AM

Plagiocephaly

Subject: [sPAM] Definity/United Healthcare paid for our helmet!

don't give up!

hello everyone!

I posted a while back about Definity/UHC not wanting to cover my son's

helmet. After denied pre-certifications, 2 denied appeals (1 sent to

the wrong place b/c I was misinformed by a UHC cust service rep), and

some of the worst customer service I have ever received, we finally

got the helmet covered.

We go to Northeast Orthotics in Providence, RI and they suggested that

even though UHC said that the helmet would not be covered, that they

submit the claim anyway. In the past some of their patients had been

told by their insurance that the helmet would not be covered, only to

pay the claim when submitted by the office.

So the moral of the story is not to give up!

Evan has been in his helmet now for 5 weeks and we already have had

measurable improvement!

I'll post my letters when I get a chance.