What does it mean to know God? Because he is complex. All we can really know is what he chooses to reveal.
Having had many different diagnoses, surgeries, and procedures I have became all too familiar with interacting with insurance companies.
In the last few years my diagnosis of breast cancer and the almost simultaneous diagnosis of our son Tristan with congenital spine and hand abnormalities has meant a level of paperwork, claims, and appeals I could never have imagined.
Navigating the maze of medical care and health insurance has become second nature to me. Having worked on this piece for weeks now, I realize the opposite is true: I just need to do my best to help. I do think my upbringing in a medical household my father was a cardiothoracic surgeon helped familiarize me with medical terminology and how to correctly present a medical history.
The fact your claim was denied is the starting point not the ending point. Persistence and determination are a large part of what it takes to win.
Physical especially congenital problems are easier to appeal than those related to developmental delays.
Black electrical wire is used for power in all circuits. Any circuit's black wire should be considered hot or live. Black wire is never used for a ground or neutral wire and should be used as the power feed for a switch or an outlet. If you would like the latest news, updates, video posting, trial information, seminars etc, please join my mail list below. It features a message in a bottle, a secret wish-making club, a book mobile, and more. It's a book about family and friendship and doing your best to help people in need.
I do know that when it comes to dealing with insurance companies those types of diagnoses are harder to quantify; this often leads to greater challenges with insurance appeals. In my experience, if the delays can be linked to anatomical problems, orthopedic issues, or diagnoses that can be validated with tests like MRIs or CTs, the case will be easier to justify.
Insurance companies must give you a reason whey they are denying a claim. Most often this reason is that 1 the treatment is experimental or investigational, 2 the treatment is not medically necessary, or 3 the treatment is not the standard of care. Be clear how it is necessary to daily functioning.
Be sure to tell what you have tried already, and what has failed. Show how your diagnosis and treatment history has brought you to this place—how there is no other reasonable option to what you are asking for or how the alternative is not preferable.
Be sure to include diagnosis codes and treatment codes your medical professional will provide these.
They may tell you that they have tried to get your service covered, it was denied and therefore this is the last word. Their office appealed the first rejection. They were again denied. Undeterred, I asked for copies of my medical records. I called my insurance company and asked what I needed to do.
In a case like this there is actually a financial disincentive for them to have insurance cover it; therefore, they may not be as aggressive as you will.
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