Insurance Victories

Successfully appealed Health Net’s denial of C Leg Prosthesis.  Order directing Health Net to pay issued from Independent Reviewer appointed by the State of California.

Successfully appealed Pennsylvania BCBS denial of new prosthetic socket, frame, pylon and foot.

Successfully appealed Cigna’s denial of Skin Tones silicone protective covering for prosthetics.

Successfully appealed Aetna’s denial of C Leg Prosthesis despite national policy to exclude device per Aetna Clinical Policy Bulletin 0578.  Order directing Aetna to pay issued from Independent Reviewer appointed by New York State.

Successfully appealed Cigna’s denial of myoelectric prosthesis that was based on “biomechanical device” exclusion.

Successfully appealed Cigna's denial of C Leg Prosthesis that was based on "biomechanical device" exclusion.

Successfully appealed Aetna's denial of replacement prosthetic socket and liners.

Successfully appealed Oxford’s denial of C Leg Prosthesis.  Order directing Oxford to pay issued from Independent Reviewer appointed by New York State.

Successfully appealed Excellus BCBS denial of C Leg Prosthesis.  Order directing BCBS to pay issued from Independent Reviewer appointed by New York State.

Successfully appealed Empire BCBS denial of C-Leg. 

Successfully appealed Aetna's denial of energy-storing prosthetic foot.

Successfully appealed Anthem BCBS denial of base code for below-knee prosthesis.

Successfully appealed HIP HMO's refusal to permit out-of-network patient to come to A Step Ahead for treatment.

Successfully appealed Empire BCBS denial of C Leg Prosthesis.  Order directing Empire to pay issued from Independent Reviewer appointed by N.Y. Dept. of Insurance at A Step Ahead's request.

Successfully appealed union's denial of C Leg Prosthesis.

Successfully appealed Aetna’s denial of C Leg Prosthesis despite national policy to exclude device per Aetna Clinical Policy Bulletin 0578.  Order directing Aetna to pay issued from Independent Reviewer appointed by New York State.

Successfully appealed Oxford's denial of prostheses, including prosthetic C Legs, for bilateral amputee. Order directing Oxford to pay issued from Independent Reviewer appointed by N.Y. Dept. of Insurance at A Step Ahead's request.

Successfully appealed HIP HMO's refusal to permit out-of-network patient to come to A Step Ahead for treatment.

Successfully appealed Medicare's denial of C Leg Prosthesis.

Successfully appealed United Healthcare's denial of claim for C Leg Prosthesis.

Successfully appealed Empire BCBS denial of claim for above-elbow myoelectric prosthesis.

Successfully appealed Aetna’s denial of C Leg Prosthesis despite national policy to exclude device per Aetna Clinical Policy Bulletin 0578. 

Successfully negotiated with HIP HMO to permit out-of-network patient to come to A Step Ahead for treatment.

Live Life without Limitations!