Medical proceedure is very nescessary but insurance refuse to cover it. How can I appeal? - cover leters
around the traditional family with one or insurer, by arbitration in the reconstruction?
United Healthcare has two separate requests to repair my hernia umbilical severe diastasis (separation of the rectus muscles denied), because of polytrauma pregnicies (3) and my word, my guts are protected ABS decending Oh my abdominal aorta by CT findings. I've tried to do to get a surgeon, but this is only a document of this type of cosmetic reconstruction ... When Tuck ... But it is not. Private insurance for them, if 4 different doctors say he should not at this too long for a small bump or kick children can lead to the break allowed me to sit intestinal septic, could come from the gut, through the navel and I need my muscles closed as soon as possible. Leters Docs have been with the company to explain in detail what is necessary, but still not those who think covering his aesthetic reasons. If the arbitration, 1, ... how ... 2. What I can say for Understna?
Wednesday, February 3, 2010
Cover Leters Medical Proceedure Is Very Nescessary But Insurance Refuse To Cover It. How Can I Appeal?
6 comments:
The question here is whether it is necessary for you. The question is whether the procedure is covered by your insurance.
If you are not able to demonstrate, United Healthcare, the reporting on this process alone. The question of "need" is irrelevant. If a process is defined in the policy as tummy, then it is covered, whether voluntary or mandatory.
Can you imagine how many people could be a doctor must certify that their "cosmetic surgery" if the insurance companies are still falling, these operations based on a "need"?
That is the reality of the insurance world. Special situations are covered if they occur, and not others, depending on which language is the usual policy and acquitted. Hundreds of people who pay really a heart transplant, not as part of its reporting, as is expressly excluded from the policy. These exclusions are usually on the policy in a position to lead the insurance premium for the company, was responsible under the policy.
My sister had a procedure for their 2 Child, as they (the repair of hernia of the navel looks done). I e-mail to see whether insurance coverage and how he did it. Her husband is a resident of surgery so maybe I have some ideas and suggestions. I come to you as soon as I heard it, I just wanted you to know that someone believes in you!
The first step is the insurance company as soon as possible and make the process of specific remedies - including a contact name or department, address, phone and fax.
Contact the doctors and ask them, letters of medical necessity - everything (write the documentation for most X-rays or something similar that shows the damage.)
Send it with your letter of complaint to insurance - keep copies of itself and follow the plan within a week or ten days after you send it to - to check the status of the resource.
Good luck!
in a study could have an end. why the insurance is not accepted because they are in business to make no $ to give, too. You pay into an account, who knows how long and in return receive nothing but a thin wallet, its sad to say. not require the best we can do is make a friend in Canada and get their address and medical help in this way. The movie SICKO by Michael Moore addresses this issue in the whole world and its sad reality in which we live, I had the opportunity to see this as it announced on MySpace, what we all need to see.
According to the American Society of Surgeons Placticamos ... The process you describe is cosmetic ... It will not be covered. Likely to refuse any request that you submitted. You probably have to rethink the process. Hernia repair is covered. If it is necessary to the abdominal wall in hernia repair is likely to be covered as well ... .... but diastase is not medically necessary is part of a normal stomach Tuck ... and has nothing to do with the hernia repair.
That the instruction in the pdf link at the bottom states of hernias, including repair of the abdominal wall is a doctor ... But that is a purely cosmetic diastase. So that's experiencing the problem with you.
Talk to your doctor, Ans, whether you are an applicant for the repair of hernias. Good luck
His demonstration of the letters is four different doctors that the condition is medically necessary and meets the need of the reasons why it is medically necessary to enumerate.
Just send us back the complaint.
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