Hi. I’m Melanie, a mom to a set of special needs twins. One has autism, and the other has a very rare chromosome disorder. So rare, it does not have a name…we can only go by “Chromosome 7 Terminal Deletion.” The chromosome disorder brings about a heart condition (Long QT Syndrome), severe developmental delays, poor muscle tone, seizures, and most recently hearing loss. In addition, my daughter is nonverbal.
I have a full-time job, so we are all covered through my employer’s insurance provider. In other words, we have private medical insurance. Despite the medical complexity of my daughter, I have recently gone through bouts of multiple medical denials for the services and durable medical equipment that she needs. Here are a few things that I have done to help get through denials from your private medical insurance company.
- Don’t take no for an answer: Despite being denied for services and equipment, most medical insurance providers will also list actions for you to take if you don’t agree with their decision. DO THIS!!
- Get a case manager: I suggest getting a case manager. They will take the lead on writing your appeal letters and send them directly to the insurance provider on your behalf. Check with your child’s doctor or medical facility to see how you can get a case manager assigned to you for help.
- Ask about loaner equipment: As mentioned before, my daughter was diagnosed with hearing loss. Rather than wait weeks for the insurance provider to determine if a particular hearing aid is covered, ask your medical professional (preferably the same on that is recommending it) if they have loaner equipment you can use. My daughter was able to get loaner hearing aids while we wait for our insurance company to make their final decision.
- DON’T GIVE UP: It’s definitely tough receiving multiple denial letters in the mail, but as long as you stay persistent and continue to fight, your hard work and determination can get you exactly what you need.
We are still in the appeal process and I’ll update the outcome on my YouTube page, TwinMomMel.
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