Re: Issues with United Healthcare - Denying coverage

[Guest guest]

Hi, the only thing I can say is UHC is pretty bad about paying for plagio. I

constantly see their name here when people complain about insurance coverage. I

hope someone who has appealed successfully will reply too.

-christine

sydney, 5 yrs, starband grad

>

> Hi Everyone,

>

> We stopped our helmet therapy last Spring, but the fight with the insurance

company continues...

>

> Does anyone have any insight/experience with UnitedHealthcare? WE referenced

everything in the database and they still will not shake that the policy says

" no coverage for cranial therapy " b/c it is considered cosmetic...despite

letters from the doctor stating it resulted from torticollis (a medical

condition)...

>

> Please share any thoughts!!

>

> Thanks

> Taj

>

[Guest guest]

You need to check with your employerks UHC rep to properly appeal. Our UHC coverage included a clause about the severity which our children did meet that criteria but it was still denied. Your employer can make the exception for the coverage with UHC. Good luck!Sent via BlackBerry by AT&TFrom: "christineashok" <christineashok@...>Sender: Plagiocephaly Date: Tue, 08 Feb 2011 10:00:53 -0000<Plagiocephaly >Reply Plagiocephaly Subject: Re: Issues with United Healthcare - Denying coverage Hi, the only thing I can say is UHC is pretty bad about paying for plagio. I constantly see their name here when people complain about insurance coverage. I hope someone who has appealed successfully will reply too.-christinesydney, 5 yrs, starband grad>> Hi Everyone,> > We stopped our helmet therapy last Spring, but the fight with the insurance company continues...> > Does anyone have any insight/experience with UnitedHealthcare? WE referenced everything in the database and they still will not shake that the policy says " no coverage for cranial therapy " b/c it is considered cosmetic...despite letters from the doctor stating it resulted from torticollis (a medical condition)...> > Please share any thoughts!!> > Thanks > Taj>

[Guest guest]

Or son has been in his helmet for twom months. Prior to ordering the helmet

Starband told us that United Health Care is notorious for denying claims. I

guess we were the lucky ones as our claim was approved under a few stipulations

which I researched before we ordered the helment. The only exclusion that our

policy had for cranail orthosis was that we needed a letter from the doctor that

deemed it medically necessary.

So, we had to have a letter of medical necessity from our pediatrician and we

had to get a precertification from the insurance comapny before persuing

treatment. Star filed the claim and after a few weeks we still didn't hear

anything so I called UHC. The rep said that it was still being processed

because the cranial orthosis requires a precertification letter which we had a

file. Then they sent us over to the RAPID RESOLUTION department and I spoke

with a rep there and they approved it. (we have had to talk to the rapid

resolution department alot after the births of our children becuase they tried

to deny claims from an in network hospital.)It definitly takes persistance.

Dont give up and from what I understand you can appeal three times and after

that you can talk to your employer about removing the exclusion in your policy.

Good Luck!

>

> Hi Everyone,

>

> We stopped our helmet therapy last Spring, but the fight with the insurance

company continues...

>

> Does anyone have any insight/experience with UnitedHealthcare? WE referenced

everything in the database and they still will not shake that the policy says

" no coverage for cranial therapy " b/c it is considered cosmetic...despite

letters from the doctor stating it resulted from torticollis (a medical

condition)...

>

> Please share any thoughts!!

>

> Thanks

> Taj

>

[Guest guest]

We are beginning this process of getting a DOC band and we also were denied

coverage by UHC last week. I submitted for a " review of benefits " thru Cranial

Tech and am still waiting to hear back. But in order to continue the treatment

we have to pay. So $3500 goes on our credit card tomorrow. Im looking for the

same answers you are....

-

> >

> > Hi Everyone,

> >

> > We stopped our helmet therapy last Spring, but the fight with the insurance

company continues...

> >

> > Does anyone have any insight/experience with UnitedHealthcare? WE referenced

everything in the database and they still will not shake that the policy says

" no coverage for cranial therapy " b/c it is considered cosmetic...despite

letters from the doctor stating it resulted from torticollis (a medical

condition)...

> >

> > Please share any thoughts!!

> >

> > Thanks

> > Taj

> >

>