Re: United Healthcare Reimbursement - Is this what I should expect?

[Guest guest]

We were very lucky to have our starband covered completely by our HMO. UHC is

known for not paying (from my experience in this group). I think you did okay.

But check the appeals section of this group in the files area, and also get a

copy of your policy and ask them for the details of why this is the portion they

covered. Once you have this info it may be easier to decide about an appeal.

-christine

sydney, 5 yrs, starband grad

>

> Is this what I should expect or can I get better? My kiddo just received

his sweet helmet but little did I know United Healthcare is not a big fan of

accepting these types of claim. That said, the total cost for this claim is

$3800. I am responsible for $2,000 of the claim along with 20% of the remainder.

This totals $2,300 out of pocket.

>

> What do I need in order to get a full reimbursement from United Healthcare? At

a minimum I'd like for them to be responsible for a larger portion of the claim.

Any advice would be GREATLY appreciated.

>

[Guest guest]

I suspect that it's your specific plan's benefit level that's getting you to

that number. Lke said, check with the insurance company. You probably

have a deductible and copay. If that's the case, that's probably the best you

will get. But give yourself a pat on the back, because that's not bad! You did

get them to pay part of the cost, and unfortunately, many parents still aren't

even getting that.

> >

> > Is this what I should expect or can I get better? My kiddo just received

his sweet helmet but little did I know United Healthcare is not a big fan of

accepting these types of claim. That said, the total cost for this claim is

$3800. I am responsible for $2,000 of the claim along with 20% of the remainder.

This totals $2,300 out of pocket.

> >

> > What do I need in order to get a full reimbursement from United Healthcare?

At a minimum I'd like for them to be responsible for a larger portion of the

claim. Any advice would be GREATLY appreciated.

> >

>

[Guest guest]

I am experiencing some of the same problems, I have UMR and that is a form of

United Health Care. When we started this process I was told by the lady who

scheduled our appt for scanning that my insurance would not cover it. After

checking into the situation 6 days before we were suppose to pick up the band I

decided to call and see if the company has submitted it to my insurance. The

company said they usually don't submit the claim until we picked up the band. I

then called my insurance and the company had lied the claim had already been

submitted 4 days prior with little to no reasoning so my insurance asked for

more medical details, again the company did not give them any so my insurance

denied the claim. While keeping very good communication with my insurance I

found out the company had requested the denial letter from my insurance so it

could be appealed by the company and my insurance would not release that to the

company without my authorization. The company not only submitted the claim, but

was going to appeal the denial without any contact with myself, and then when

the band came in I would have been out of luck because once the appeal has been

denied nothing can be done even if you had no idea. So I am thankful I kept in

contact with the insurance company. So everyone be sure to check on your status

of your claims, ask questions, continue to call keep record of who you talk to.

4 days till we get the band

> >

> > Is this what I should expect or can I get better? My kiddo just received

his sweet helmet but little did I know United Healthcare is not a big fan of

accepting these types of claim. That said, the total cost for this claim is

$3800. I am responsible for $2,000 of the claim along with 20% of the remainder.

This totals $2,300 out of pocket.

> >

> > What do I need in order to get a full reimbursement from United Healthcare?

At a minimum I'd like for them to be responsible for a larger portion of the

claim. Any advice would be GREATLY appreciated.

> >

>