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More archives for:
PRIRA Cases: 2009 | 2008 | 2007 | 2003 | 2002

2009:			March - February - January
	March
		• 30 -	BCBSM 101789 - Covered benefit; routine physical
		• 30 -	USHL 102793 - Covered benefit; out-of-network ambulance service
		• 30 -	GOLDEN RULE 102876 - Covered benefit; outpatient surgery
		• 30 -	TIME 102976 - Medical necessity; chiropractic treatment
		• 30 -	MIDWEST SECURITY 102979 - Covered benefit; gynecomastia
		• 30 -	MIDWEST SECURITY 102455 - Medical necessity; chiropractic treatment
		• 30 -	AETNA 102559 - Covered benefit; chiropractic treatment
		• 24 -	MIDWEST SECURITY 103038 - Out-of-network surgery
		• 20 -	USHL 103346 - Experimental treatment; Botox injection for migraine
		• 20 -	WORLD 102862 - Out-of-network surgery; usual and customary charge
		• 20 -	BCBSM 101652 - Covered benefit; dental care
		• 20 -	UNITED HEALTHCARE 103750 - Medical necessity; mental health partial hospitalization
		• 20 -	JOHN ALDEN 102685 - Out-of-network services; emergency care
		• 20 -	BCBSM 101654 - Covered benefit; physical therapy
		• 20 -	BCBSM 101715 - Covered benefit; nonpanel surgery
		• 19 -	BCBSM 101134 - Medical necessity; residential mental health treatment
		• 19 -	BCBSM 101651 - Covered benefit; antineoplastic infusion pump
		• 19 -	UNITED HEALTHCARE 102737 -Policy exclusion; alcohol and fighting
		• 18 -	BCN 102650 - Covered benefit; in vitro fertilization
		• 16 -	AMERICAN MEDICAL 90898 - Covered benefit; mental health treatment
		• 16 -	BCBSM 101586 - Covered benefit; orthodontic care
		• 16 -	PRIORITY HEALTH 102499 - Medical necessity; prophylactic mastectomies
		• 16 -	BCBSM 101615 - Covered benefit; dental implants
		• 16 -	WORLD 102684 - Preexisting condition limitation
		• 12 -	HUMANA 102724 - Covered benefit; out-of-network psychotherapy
		• 12 -	HUMANA 101932 - Covered benefit; thermal massage bed
	February
		• 27 -	MIDWEST SECURITY 102298 - Medical necessity; pain relief injections
		• 27 -	JOHN ALDEN 101138 - Experimental or investigational treatment; erectile dysfunction
		• 27 -	GUARDIAN 102521 - Covered benefit; dental bridge
		• 27 -	HUMANA 101768 - Covered benefit; physical therapy
		• 27 -	USHL 101656 - Covered benefit; out-of-network ambulance transport
		• 27 -	BCBSM 101348 - Covered benefit; speech therapy
		• 25 -	TIME 101817 - Pre-existing condition limitation
		• 24 -	BCBSM 101139 - Out-of-network surgery
		• 24 -	UNITED HEALTHCARE 101766 - Out-of-network surgery
		• 24 -	BCBSM 100924 - Covered benefit; immunization
		• 24 -	TRUSTMARK 101353 - Covered benefit; dental care
		• 23 -	BCBSM 100841 - Out-of-network surgery
		• 23 -	BCBSM 101025 - Out-of-network provider; home infusion therapy
		• 23 -	PHPMM 102516 - Out-of-network consultation
		• 23 -	BCBSM 101096 - Covered benefit; endodontic care
		• 17 -	BCBSM 100784 - Experimental treatment; vagus nerve stimulation
		• 17 -	BCBSM 101000 - Covered benefit; occupational therapy
		• 17 -	GOLDEN RULE 101509 - Pre-existing condition limitation
		• 09 -	BCN 102832 - Medical necessity; electroconvulsive therapy
		• 06 -	BCN 101440 - Out-of-network surgery
	January
		• 30 -	PHPMM 102069 - Covered benefit; office visit
		• 30 -	BCBSM 100883 - Covered benefit; immunizations
		• 23 -	BCBSM 100834 - Covered benefit; infant formula
		• 23 -	UNITED HEALTHCARE 89601 - Out-of-network service; surgery
		• 22 -	BCBSM 100237 - Covered benefit; dental care after accident
		• 20 -	GOLDEN RULE 100782 - Treatment for pregnancy complications, policy exclusion
		• 20 -	USHL 100893 - Medical necessity; air ambulance transport
		• 20 -	PARAMOUNT 100681 - Laser treatment for skin disorder, policy exclusion
		• 20 -	HUMANA 100671 - Experimental treatment, Botox treatment for urology disorder
		• 20 -	BCBSM 100388 - Policy exclusion; feeding/speech therapy
		• 20 -	BCBSM 100178 - Policy exclusion; diabetes care device
		• 20 -	BCBSM 90587 - Covered benefit; jaw surgery
		• 20 -	BCBSM 87766 - Experimental treatment; radio frequency ablation therapy
		• 20 -	PRIORITY HEALTH 102034 - Out-of-network service; mental health therapy
		• 20 -	BCN 101962 - Wellness program eligibility
		• 20 -	PRIORITY HEALTH 101880 - Covered benefit; foot orthotics
		• 20 -	TIME 101852 - Covered benefit; emergency room services
		• 20 -	BCN 101240 - Out-of-network service; spinal surgery
		• 20 -	PHPMM 100923 - Out-of-network service; endocrinologist
		• 13 -	HAP 90919-Prescription drug restrictions
		• 06 -	HAP 101369-Out-of-network service; eye surgery
		• 06 -	PRIORITY HEALTH 101071-Wellness program eligibility
		• 06 -	HAP 101515-Coordination of benefits


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