How to work with appeals + denials

Did you receive a denial? Don’t be discouraged; we are here to help. 

In this article, we will cover how to continue to advocate for your loved one's needs even after an insurance/Medicaid denial and how to get started with an appeal. At Cubby, we are in your corner and are here to further guide you on moving forward after a denial from insurance with resources. We know it can be hard not to become discouraged when this happens. Do not give up! 💪

Your Medical Supplier will continue to play a crucial role in getting a Cubby Bed through insurance/Medicaid even if you wish to do an appeal. If you receive a denial, please partner with the supplier to ask for the next steps to get started with an appeal or resubmission. They have a team who are experts in your specific state and local guidelines.

• Denials are not uncommon; families can get their denial overturned and receive approval in the appeal process

• You will still need a Medical Supplier to assist you with the appeal process, so it is best to continue working with the same supplier.

• The supplier's team is the expert on your specific state laws, policy requirements, and how best to assist with appeals.

• Cubby has a Care Team available to review denial documentation and Letters of Medical Necessity (LMN) to assist with where to improve documentation. This is not a guarantee for approval — it is, however, a very helpful service offered to ensure each safety feature of the Cubby Bed is associated with your loved one’s unique behaviors.

• The most common reasons for denial stem from not having a detailed letter of medical necessity (LMN). It is highly recommended that the LMN submitted to your insurance/Medicaid be reviewed and possibly revised before re-submitting the appeal process. You will need to involve your medical provider in editing the LMN.

• The average time to process an appeal is 1 - 2 months. Do not get discouraged by this, as the end results can be life-changing for you and your family!

• When resubmitting, the original documentation will need to be updated, or new documentation that supports the medical need of the Cubby Bed will need to be added.

The first step in the appeal process is starting with reviewing all of the original documentation that was submitted. There are a couple of ways to do that:

Our Care Team at Cubby Beds

• How we help: A thorough review of the LMN from a Care Team member on all of Cubby Bed's safety, sleep, and sensory features can be incredibly insightful. They can help connect these features to your loved one's diagnosis and how they would benefit their unique behaviors.

• If you are interested in getting your LMN and/or denial documents reviewed, click here to fill out our form and attach the documentation for the specialist. It is best to include the following attachments to the form:

  • Insurance/Medicaid reason for denial document

  • Letter of Medical Necessity (LMN) that was submitted to Insurance/Medicaid

Please note: At this time, a completed review takes 7-10 business days. A Cubby Care team member will reach out to you within this time frame regarding the findings from the review. 

Another option is to begin to look at alternative funding sources to insurance/Medicaid. Please click here to view our other funding options, which include waivers, charities, financing options, and private pay.

 Please reach out to our Cubby Care Team for more questions at hello@cubbybeds.com