UHC Insurance - Overriding an Exclusion

[Guest guest]

We are still working on our appeal to UHC for DOC Band coverage. Our initial

claim and first appeal were both denied. My understanding now is that a second

appeal would likely have the same outcome. The last resort is to see if our

employer can get UHC to override the exclusion. Anyone have experience with

this that led to coverage? If so, would be interested in what you did and your

experience. Tips and suggestions welcome, too!

Jill

mom to Cade, 8 months, DOC Band graduate 8/5/09

Texas

[Guest guest]

Hey Jill,

Looks like we are on the same path, unfortunately. I just received word

yesterday that the 2nd level appeal was denied as well.

I did talk to my employer and apparently some of the " higher ups " at my company

heard about my problem and are working with the UHC company rep to work

something out. Not sure it will happen, but they told me that the rep was

looking into making sure I am covered this year and next for all issues related

to the plagiocephaly. I'll let you know if I hear any more info than that.

Weird thing is, Hanger received payment for the helmet. I called UHC and they

have no record of the payment, but Hanger credited us for it so we aren't

complaining at the moment, but it wouldn't surprise me if UHC made an error and

bills Hanger again.

good luck.

-

>

> We are still working on our appeal to UHC for DOC Band coverage. Our initial

claim and first appeal were both denied. My understanding now is that a second

appeal would likely have the same outcome. The last resort is to see if our

employer can get UHC to override the exclusion. Anyone have experience with

this that led to coverage? If so, would be interested in what you did and your

experience. Tips and suggestions welcome, too!

>

> Jill

> mom to Cade, 8 months, DOC Band graduate 8/5/09

> Texas

>

[Guest guest]

,

I was hoping to hear that your appeal efforts led to a reversal of the previous

denials. Sorry to hear we're in the same boat. Our HR department is working on

it, but they didn't sound very optimistic. We'll see. That's interesting that

Hangar received payment for the helmet. Maybe we should start praying that CT

gets a random check from UHC to cover ours, too! :-) Let me know if your

employer is able to override the exclusion. Hopefully, we'll both have good

news to report on that in the next couple of weeks.

Jill

> >

> > We are still working on our appeal to UHC for DOC Band coverage. Our

initial claim and first appeal were both denied. My understanding now is that a

second appeal would likely have the same outcome. The last resort is to see if

our employer can get UHC to override the exclusion. Anyone have experience with

this that led to coverage? If so, would be interested in what you did and your

experience. Tips and suggestions welcome, too!

> >

> > Jill

> > mom to Cade, 8 months, DOC Band graduate 8/5/09

> > Texas

> >

>