There's nothing that makes our blood boil more than when an insurance denies a necessary service or equipment. But in our world this is bound to happen.
So what do you do? You roll up your sleeves and get to work. The first time this happened I wasn't sure where to start. Here are some things to help you get started winning your own appeal...
1) You will likely need letters of support from specialists and physicians. Make a list of all the provider(s) that could support your need. Then contact them ASAP! It can take doctors weeks to put together a letter. Call once a week to keep them working!
2) Think about all the reasons why the denied support is necessary for your child. How will he/she benefit? Every reason matters.
3) Everything is about money. Show the how it will be cost effective for them to pay for this support. When nursing care was denied I went through all our insurance statements (Yes...this took HOURS). I included exactly how much it costs for medications, therapies, EEGs, hospitalizations, etc. I then explained in detail, bullet by bullet, how homecare nursing can help prevent the need for MORE. And, consequently, save them money.
Here is a link I used to help structure my own letters: Writing Winning Insurance Appeal Letters.