Insurance appeal for Respirtech vest

[Jenica]

Hello, our claim for Ellie's Respirtech vest was recently denied. I'm starting the appeals process and was hoping for some help ...

Our claim was denied for being out-of-network, which is pretty silly considering we our network is New England and the only three vest manufacturers are all in Minnesota. I understand that we need to file our appeal seeking individual consideration, but I want to make sure that our appeal is as strong as possible. I don't want to drag this out any further, plus I'm not sure how difficult it is once the appeal has been denied.

Would anyone with similar circumstances be willing to share their letter of appeal? Or any tips or suggestions?

Thanks so much!

 

[Jenica]

Hello, our claim for Ellie's Respirtech vest was recently denied. I'm starting the appeals process and was hoping for some help ...

Our claim was denied for being out-of-network, which is pretty silly considering we our network is New England and the only three vest manufacturers are all in Minnesota. I understand that we need to file our appeal seeking individual consideration, but I want to make sure that our appeal is as strong as possible. I don't want to drag this out any further, plus I'm not sure how difficult it is once the appeal has been denied.

Would anyone with similar circumstances be willing to share their letter of appeal? Or any tips or suggestions?

Thanks so much!

 

[Jenica]

Hello, our claim for Ellie's Respirtech vest was recently denied. I'm starting the appeals process and was hoping for some help ...

Our claim was denied for being out-of-network, which is pretty silly considering we our network is New England and the only three vest manufacturers are all in Minnesota. I understand that we need to file our appeal seeking individual consideration, but I want to make sure that our appeal is as strong as possible. I don't want to drag this out any further, plus I'm not sure how difficult it is once the appeal has been denied.

Would anyone with similar circumstances be willing to share their letter of appeal? Or any tips or suggestions?

Thanks so much!

 

[Jenica]

Hello, our claim for Ellie's Respirtech vest was recently denied. I'm starting the appeals process and was hoping for some help ...

Our claim was denied for being out-of-network, which is pretty silly considering we our network is New England and the only three vest manufacturers are all in Minnesota. I understand that we need to file our appeal seeking individual consideration, but I want to make sure that our appeal is as strong as possible. I don't want to drag this out any further, plus I'm not sure how difficult it is once the appeal has been denied.

Would anyone with similar circumstances be willing to share their letter of appeal? Or any tips or suggestions?

Thanks so much!

 

[Jenica]

Hello, our claim for Ellie's Respirtech vest was recently denied. I'm starting the appeals process and was hoping for some help ...
<br />
<br />Our claim was denied for being out-of-network, which is pretty silly considering we our network is New England and the only three vest manufacturers are all in Minnesota. I understand that we need to file our appeal seeking individual consideration, but I want to make sure that our appeal is as strong as possible. I don't want to drag this out any further, plus I'm not sure how difficult it is once the appeal has been denied.
<br />
<br />Would anyone with similar circumstances be willing to share their letter of appeal? Or any tips or suggestions?
<br />
<br />Thanks so much!

 

[lightNlife]

I'm currently going through the same thing. Insurance said they'd pay for the HillRom version, but not the Respirtech. I don't have success with the HillRom one, which is what I mentioned in my appeal letter. In your letter you might want to mention that the Respirtech Vest costs less than the HillRom.

I'll see if I can find my letter and post it for you. Good luck!

 

[lightNlife]

I'm currently going through the same thing. Insurance said they'd pay for the HillRom version, but not the Respirtech. I don't have success with the HillRom one, which is what I mentioned in my appeal letter. In your letter you might want to mention that the Respirtech Vest costs less than the HillRom.

I'll see if I can find my letter and post it for you. Good luck!

 

[lightNlife]

I'm currently going through the same thing. Insurance said they'd pay for the HillRom version, but not the Respirtech. I don't have success with the HillRom one, which is what I mentioned in my appeal letter. In your letter you might want to mention that the Respirtech Vest costs less than the HillRom.

I'll see if I can find my letter and post it for you. Good luck!

 

[lightNlife]

I'm currently going through the same thing. Insurance said they'd pay for the HillRom version, but not the Respirtech. I don't have success with the HillRom one, which is what I mentioned in my appeal letter. In your letter you might want to mention that the Respirtech Vest costs less than the HillRom.

I'll see if I can find my letter and post it for you. Good luck!

 

[lightNlife]

I'm currently going through the same thing. Insurance said they'd pay for the HillRom version, but not the Respirtech. I don't have success with the HillRom one, which is what I mentioned in my appeal letter. In your letter you might want to mention that the Respirtech Vest costs less than the HillRom.
<br />
<br />I'll see if I can find my letter and post it for you. Good luck!

 

[SaltyAndSweet]

Hi lightNlife
Can you please post your letter here? or directions to get to it? I may have to go through the fight to get a Smart Vest (or something other than HillRom, which doesn't work for me either), if I decide I can mentally handle another insurance fight.
Thank you!

 

[SaltyAndSweet]

Hi lightNlife
Can you please post your letter here? or directions to get to it? I may have to go through the fight to get a Smart Vest (or something other than HillRom, which doesn't work for me either), if I decide I can mentally handle another insurance fight.
Thank you!

 

[SaltyAndSweet]

Hi lightNlife
Can you please post your letter here? or directions to get to it? I may have to go through the fight to get a Smart Vest (or something other than HillRom, which doesn't work for me either), if I decide I can mentally handle another insurance fight.
Thank you!

 

[SaltyAndSweet]

Hi lightNlife
Can you please post your letter here? or directions to get to it? I may have to go through the fight to get a Smart Vest (or something other than HillRom, which doesn't work for me either), if I decide I can mentally handle another insurance fight.
Thank you!

 

[SaltyAndSweet]

Hi lightNlife
<br />Can you please post your letter here? or directions to get to it? I may have to go through the fight to get a Smart Vest (or something other than HillRom, which doesn't work for me either), if I decide I can mentally handle another insurance fight.
<br />Thank you!
<br />

 

[lightNlife]

Here's my letter. Feel free to edit it to suit your own needs.


<div class="FTQUOTE"><begin quote>To Whom It May Concern:

I am requesting that you reconsider your decision to deny coverage for the Respirtech InCourage chest compression device.

I am a patient with cystic fibrosis. Cystic fibrosis is a progressive genetic disorder that primarily affects the respiratory system. People with cystic fibrosis are prone to pneumonia and other serious lung infections
because the abnormally thick, sticky mucus produced by their body accumulates in the lungs and airways and is difficult to clear out by simple coughing.

I currently utilize the following airway clearance techniques:

-use of bronchodilators
-nebulized mucolytics
-postural drainage and manual chest percussive therapy
-positive expiratory pressure (PEP) therapy using a Quake and Acapella

Under a previous insurance provider I had been able to obtain a Hill-Rom vest system. I was very dissatisfied with it because it was ineffective in helping to loosen my secretions. I continued to use 1999-2003, at which time it became more beneficial for me to have a caregiver (my spouse) administer manual chest percussive therapy.

My lifestyle changed and regular, twice daily chest percussive therapy was no longer feasible for me as an active adult. I travel for work and had to rely on PEP therapy and mucolytics when alone on business trips. This was not nearly as effective as having my husband perform manual CPT, and I suffered more frequent lung infections and had to endure a series of hospital stays.

In May, 2007 I inquired of Dr. Conrad's nurse at the UCSD Cystic Fibrosis Adult Clinic if there were any new developments in the types of chest percussion devices. I wanted something that I could do on my own, that was effective as an airway clearance device. I was given an opportunity to demo the Respirtech InCourage vest system for several months. Respirtech's system brought about benefits immediately. The first time I used it I was able to cough out secretions. I have continued to use it, and during that 8 month trial I only had 1 lung exacerbation requiring hospitalization, as compared to 6 in the previous calendar year.

The InCourage Vest from Respirtech has proved to be far superior to the Hill-Rom Vest in my situation. I have been able to travel with the Respirtech InCourage Vest, which is a wonderful quality of life issue. Furthermore, the cost of the Respirtech InCourage Vest in minimal when you consider the money being saved on hospital bills and prescriptions for antibiotics to fight respiratory infections. The Hill-Rom Vest does not work for me. The Respirtech InCourage Vest does.

Respectfully,
</end quote></div>

 

[lightNlife]

Here's my letter. Feel free to edit it to suit your own needs.


<div class="FTQUOTE"><begin quote>To Whom It May Concern:

I am requesting that you reconsider your decision to deny coverage for the Respirtech InCourage chest compression device.

I am a patient with cystic fibrosis. Cystic fibrosis is a progressive genetic disorder that primarily affects the respiratory system. People with cystic fibrosis are prone to pneumonia and other serious lung infections
because the abnormally thick, sticky mucus produced by their body accumulates in the lungs and airways and is difficult to clear out by simple coughing.

I currently utilize the following airway clearance techniques:

-use of bronchodilators
-nebulized mucolytics
-postural drainage and manual chest percussive therapy
-positive expiratory pressure (PEP) therapy using a Quake and Acapella

Under a previous insurance provider I had been able to obtain a Hill-Rom vest system. I was very dissatisfied with it because it was ineffective in helping to loosen my secretions. I continued to use 1999-2003, at which time it became more beneficial for me to have a caregiver (my spouse) administer manual chest percussive therapy.

My lifestyle changed and regular, twice daily chest percussive therapy was no longer feasible for me as an active adult. I travel for work and had to rely on PEP therapy and mucolytics when alone on business trips. This was not nearly as effective as having my husband perform manual CPT, and I suffered more frequent lung infections and had to endure a series of hospital stays.

In May, 2007 I inquired of Dr. Conrad's nurse at the UCSD Cystic Fibrosis Adult Clinic if there were any new developments in the types of chest percussion devices. I wanted something that I could do on my own, that was effective as an airway clearance device. I was given an opportunity to demo the Respirtech InCourage vest system for several months. Respirtech's system brought about benefits immediately. The first time I used it I was able to cough out secretions. I have continued to use it, and during that 8 month trial I only had 1 lung exacerbation requiring hospitalization, as compared to 6 in the previous calendar year.

The InCourage Vest from Respirtech has proved to be far superior to the Hill-Rom Vest in my situation. I have been able to travel with the Respirtech InCourage Vest, which is a wonderful quality of life issue. Furthermore, the cost of the Respirtech InCourage Vest in minimal when you consider the money being saved on hospital bills and prescriptions for antibiotics to fight respiratory infections. The Hill-Rom Vest does not work for me. The Respirtech InCourage Vest does.

Respectfully,
</end quote></div>

 

[lightNlife]

Here's my letter. Feel free to edit it to suit your own needs.


<div class="FTQUOTE"><begin quote>To Whom It May Concern:

I am requesting that you reconsider your decision to deny coverage for the Respirtech InCourage chest compression device.

I am a patient with cystic fibrosis. Cystic fibrosis is a progressive genetic disorder that primarily affects the respiratory system. People with cystic fibrosis are prone to pneumonia and other serious lung infections
because the abnormally thick, sticky mucus produced by their body accumulates in the lungs and airways and is difficult to clear out by simple coughing.

I currently utilize the following airway clearance techniques:

-use of bronchodilators
-nebulized mucolytics
-postural drainage and manual chest percussive therapy
-positive expiratory pressure (PEP) therapy using a Quake and Acapella

Under a previous insurance provider I had been able to obtain a Hill-Rom vest system. I was very dissatisfied with it because it was ineffective in helping to loosen my secretions. I continued to use 1999-2003, at which time it became more beneficial for me to have a caregiver (my spouse) administer manual chest percussive therapy.

My lifestyle changed and regular, twice daily chest percussive therapy was no longer feasible for me as an active adult. I travel for work and had to rely on PEP therapy and mucolytics when alone on business trips. This was not nearly as effective as having my husband perform manual CPT, and I suffered more frequent lung infections and had to endure a series of hospital stays.

In May, 2007 I inquired of Dr. Conrad's nurse at the UCSD Cystic Fibrosis Adult Clinic if there were any new developments in the types of chest percussion devices. I wanted something that I could do on my own, that was effective as an airway clearance device. I was given an opportunity to demo the Respirtech InCourage vest system for several months. Respirtech's system brought about benefits immediately. The first time I used it I was able to cough out secretions. I have continued to use it, and during that 8 month trial I only had 1 lung exacerbation requiring hospitalization, as compared to 6 in the previous calendar year.

The InCourage Vest from Respirtech has proved to be far superior to the Hill-Rom Vest in my situation. I have been able to travel with the Respirtech InCourage Vest, which is a wonderful quality of life issue. Furthermore, the cost of the Respirtech InCourage Vest in minimal when you consider the money being saved on hospital bills and prescriptions for antibiotics to fight respiratory infections. The Hill-Rom Vest does not work for me. The Respirtech InCourage Vest does.

Respectfully,
</end quote></div>

 

[lightNlife]

Here's my letter. Feel free to edit it to suit your own needs.


<div class="FTQUOTE"><begin quote>To Whom It May Concern:

I am requesting that you reconsider your decision to deny coverage for the Respirtech InCourage chest compression device.

I am a patient with cystic fibrosis. Cystic fibrosis is a progressive genetic disorder that primarily affects the respiratory system. People with cystic fibrosis are prone to pneumonia and other serious lung infections
because the abnormally thick, sticky mucus produced by their body accumulates in the lungs and airways and is difficult to clear out by simple coughing.

I currently utilize the following airway clearance techniques:

-use of bronchodilators
-nebulized mucolytics
-postural drainage and manual chest percussive therapy
-positive expiratory pressure (PEP) therapy using a Quake and Acapella

Under a previous insurance provider I had been able to obtain a Hill-Rom vest system. I was very dissatisfied with it because it was ineffective in helping to loosen my secretions. I continued to use 1999-2003, at which time it became more beneficial for me to have a caregiver (my spouse) administer manual chest percussive therapy.

My lifestyle changed and regular, twice daily chest percussive therapy was no longer feasible for me as an active adult. I travel for work and had to rely on PEP therapy and mucolytics when alone on business trips. This was not nearly as effective as having my husband perform manual CPT, and I suffered more frequent lung infections and had to endure a series of hospital stays.

In May, 2007 I inquired of Dr. Conrad's nurse at the UCSD Cystic Fibrosis Adult Clinic if there were any new developments in the types of chest percussion devices. I wanted something that I could do on my own, that was effective as an airway clearance device. I was given an opportunity to demo the Respirtech InCourage vest system for several months. Respirtech's system brought about benefits immediately. The first time I used it I was able to cough out secretions. I have continued to use it, and during that 8 month trial I only had 1 lung exacerbation requiring hospitalization, as compared to 6 in the previous calendar year.

The InCourage Vest from Respirtech has proved to be far superior to the Hill-Rom Vest in my situation. I have been able to travel with the Respirtech InCourage Vest, which is a wonderful quality of life issue. Furthermore, the cost of the Respirtech InCourage Vest in minimal when you consider the money being saved on hospital bills and prescriptions for antibiotics to fight respiratory infections. The Hill-Rom Vest does not work for me. The Respirtech InCourage Vest does.

Respectfully,
</end quote>

 

[lightNlife]

Here's my letter. Feel free to edit it to suit your own needs.
<br />
<br />
<br /><div class="FTQUOTE"><begin quote>To Whom It May Concern:
<br />
<br />I am requesting that you reconsider your decision to deny coverage for the Respirtech InCourage chest compression device.
<br />
<br />I am a patient with cystic fibrosis. Cystic fibrosis is a progressive genetic disorder that primarily affects the respiratory system. People with cystic fibrosis are prone to pneumonia and other serious lung infections
<br />because the abnormally thick, sticky mucus produced by their body accumulates in the lungs and airways and is difficult to clear out by simple coughing.
<br />
<br />I currently utilize the following airway clearance techniques:
<br />
<br /> -use of bronchodilators
<br /> -nebulized mucolytics
<br /> -postural drainage and manual chest percussive therapy
<br /> -positive expiratory pressure (PEP) therapy using a Quake and Acapella
<br />
<br />Under a previous insurance provider I had been able to obtain a Hill-Rom vest system. I was very dissatisfied with it because it was ineffective in helping to loosen my secretions. I continued to use 1999-2003, at which time it became more beneficial for me to have a caregiver (my spouse) administer manual chest percussive therapy.
<br />
<br />My lifestyle changed and regular, twice daily chest percussive therapy was no longer feasible for me as an active adult. I travel for work and had to rely on PEP therapy and mucolytics when alone on business trips. This was not nearly as effective as having my husband perform manual CPT, and I suffered more frequent lung infections and had to endure a series of hospital stays.
<br />
<br />In May, 2007 I inquired of Dr. Conrad's nurse at the UCSD Cystic Fibrosis Adult Clinic if there were any new developments in the types of chest percussion devices. I wanted something that I could do on my own, that was effective as an airway clearance device. I was given an opportunity to demo the Respirtech InCourage vest system for several months. Respirtech's system brought about benefits immediately. The first time I used it I was able to cough out secretions. I have continued to use it, and during that 8 month trial I only had 1 lung exacerbation requiring hospitalization, as compared to 6 in the previous calendar year.
<br />
<br />The InCourage Vest from Respirtech has proved to be far superior to the Hill-Rom Vest in my situation. I have been able to travel with the Respirtech InCourage Vest, which is a wonderful quality of life issue. Furthermore, the cost of the Respirtech InCourage Vest in minimal when you consider the money being saved on hospital bills and prescriptions for antibiotics to fight respiratory infections. The Hill-Rom Vest does not work for me. The Respirtech InCourage Vest does.
<br />
<br />Respectfully,
<br /></end quote>
<br />
<br />