Out of Network Insurance Coverage

[Guest guest]

I am sure that someone has already delved on this issue before and a lot of the

members have posted their insight and feedback on the same.

My question is similar - I live in NJ and I do not have out of network coverage

and the insurance company Health Net denied the pre-certification for reasons

that there are in network providers who do the same instead of Cranial

Technologies who is considered out of network.

I have already started of on the treatment for my son who is 13 months old and

today he got his band. I have already paid for it and want to submit a claim to

my insurance company with an explanation that the 2 that they suggested were not

in the proximity or geographical locale where I live and would be difficult for

me to take time off work and go for the routine evaluation, 3d imaging, fitting

, adjustments etx.

I did call the other 2 providers and they first of all were not FDA approved and

they had custom made and off the shelf helmets and after speaking to them was

not very convinced other than satisfying my insurance company.

Has anyone had a similar situation and what were their methods of handling it

and outcome if any.

Owen