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Lifevest Case Study

Satisfactory Essays

We received notice that Aetna has denied our LifeVest claim for Ms. Sanders’ due to ZOLL being an Out-of-Network provider. Please consider this a formal appeal requesting an exception to reprocess Ms. Sanders’ claim using her In-Network benefits. Because ZOLL is the SOLE Manufacturer/provider worldwide for the FDA Class III approved Wearable Cardioverter Defibrillator, Ms. Sanders had no option to obtain the LifeVest from an In-Network provider. Mark Mines, MD prescribed the LifeVest to Ms. Sanders to monitor and protect her from Sudden Cardiac Death. Ms. Sanders did not leave her coverage area to obtain the LifeVest. Although the LifeVest is manufactured in Pittsburgh, PA, it is often shipped to the home of the patient or fitted in the

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