Bilateral amputee told prosthetics not medically necessary by insurance provider ??

Bilateral amputee told prosthetics not medically necessary by insurance provider ??

Anthony T. Barr

11/3/2002

From: <Email Address Redacted>
To: Cheryl B
Cc: <Email Address Redacted>
Sent: Friday, November 01, 2002 12:17 PM
Subject: Re: Preliminary Questions regarding bilateral amputee needs for prosthetic rehabilitation


  Cheryl,
  I am not aware of Pennsylvania's coverage available thru Medicaid or other state resources.
  I have cc your request to the O&P Listerve in hopes of generating suggestions from practitioners and the needed guidance for you to pursue. I cant understand the reasoning for not being medically necessary as a reason in denying coverage,but perhaps some of the O&P subscribers could shed light on that.
  Our funding process would require denial letters of coverage from all available resources and a sponsoring qualified prosthetist be located and the patient be determined eligible for our funding.
  Tony Barr
  Barr Foundation
  www.oandp.com/barr
    ----- Original Message -----
    From: Cheryl B
    To: <Email Address Redacted>
    Sent: Thursday, October 31, 2002 1:54 PM
    Subject: Preliminary Questions


    Good afternoon. I'm just beginning some 'research' into what may or may not be able to be done for a gentlemen living in my neighborhood of Pennsylvania . I don't now have all the specifics of his case but what I do know is that he has neither leg below the knee (a birth defect) ~ is in his 40's ~ and his insurance company is denying him limbs saying they are not medically necessary. Can you give me some guidance as to where to start the process of perhaps doing a major fund-raiser to help with the overwhelming cost of a new set of prosthetics??? Can you give me more information on your program of applying to receive assistance????

    Thank you so much!
    Cheryl Boulanger