Re: Need Help - Anyone been successful in getting UHC to cover the DOC Band?

April 11, 2011

YES, thank you for sharing and uploading your appeal letter. We have found a way

to pay for the band, but still feel it is imperative to do all we can to get

insurance like UHC to realize this is something that should be covered!! I hope

to do what I can and appreciate any help.

> > >

> > > I am currently about to begin the appeals process with UHC to get my

> daughters DOC band covered. Her first band received a denial because they

> said Cranial was Out-Of-Network, and my plan didn't provide out of network

> coverage. Well, effective 4/1, I am now on the UHC PPO plan, and I do have

> Out of Network coverage...since my daughter outgrew her first band, and

> still needs further treatment, we are going with a 2nd band, prescribed by

> her pediatrician, as her plagiocephaly is still considered severe even after

> the first band. Well, UHC has once again denied the claim citing the

> following exclusion " Braces that straighten or change the shape of a body

> part are orthotic devices, and are excluded from coverage. "

> > >

> > > I'm wondering if anyone has appealed UHC under this denial reason, and

> been successful? If so, I would truly appreciate it if you would be willing

> to share your letter, and supporting documentation that was provided with

> the appeal. Also, if I could cite you within my appeal letter to prove a

> point that it has been covered for others, and that this is considered

> discrimination of some sort against my daughter? Just looking for anything

> I can on this.

> > >

> > > My husbands parents were gracious and kind enough to pay for our

> daughters first band, and have offered to pay for this 2nd one, but I cannot

> in good conscience take their money without putting up one heck of a fight

> with the insurance company to get it back!!! Please, please help if you

> can.

> > >

> > > Thanks!

> > >

> >

>

> ------------------------------------

>

> For more plagio info

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