UGH!

[Guest guest]

It probably went better than you think you know you have them shaking

in their boots with the bead press anyhow-we had UHC and got coverage but I

swear it was under the DME rider. Please let us know how it turns out and let

me know if there is anything I can do to help you!

Assplosion- I love it chuckle chuckle!

beck

[Guest guest]

,

Sounds like you did a great job at the appeal- good for you!!! I'm sure they

are hating you for putting the potential spotlight on them, but they gotta

love your determination! I really, really hope you win and send lots of

luck your way! Stay positive, you never know what can happen! I got a

chuckle out of the assplosion myself- boy do I know what that's like!!! It

seems they know when your at important meetings or appts. to let loose, it

never fails!! Good luck and let us know as soon as you hear something, we

are all pulling for good news!

' Mom

[Guest guest]

Well my appeal hearing is over. I have no idea how it went. I was

suppossed to call dh and conference him in, but of course he didn't

have his cell phone on. He realized this 5 minutes into the call

and kept beeping through the call waiting. Boy that was annoying!

I lost my voice (which happens all the time since Dane was born?).

Dane was also nice enough to have an assplosion that got his clothes

all dirty.

They asked me how I could not consider it an orthotic when CT's

paperwork to the FDA names it as an Cranial Orthosis. I said it was

in a separate category than a regular orthotic because it is

shaping/molding the head. A foot orthotic simply provides support.

I also stated that UHC classified the DOC Band as DME unless someone

had an orthotics exclusion and then it was conveniently called an

orthotic. I also stated inconsistencies with IRISA and how they are

out of compliance.

They asked to the WSJ reporters names and phone numbers. My friend

said to tell them the WSJ is interested in doing a story on how

HMO's pay for plagio treatmet (or don't pay for it) and they are

using our case as the news peg (and 's too). They actually

are interested in doing a story. They couldn't believe how we were

treated. UHC would be smart to take action on this and revise their

policies. Bad press in the WSJ can drive their stock price down and

cost them a lot more in lost stock revenue than bands/helmet will

ever cost them.

We'll see how it goes from here. I will find out in 5 days. I have

already opened my complaint file with the Department of Insurance. I

will take it as far as permitted by law.

Dane's mom (DOC Band 2/14)

[Guest guest]

You go girl...I am on the same road as you...but I am not to the appeal stage yet they conviently lost all of my paper work so they had to start over...Good Luck sounds like you are very strong and in this for the long haul and thats what our babies need...Hugs

Trisha

-----Original Message-----From: rmanias [mailto:rmanias@...]Sent: Wednesday, May 08, 2002 10:07 AMPlagiocephaly Subject: UGH!Well my appeal hearing is over. I have no idea how it went. I was suppossed to call dh and conference him in, but of course he didn't have his cell phone on. He realized this 5 minutes into the call and kept beeping through the call waiting. Boy that was annoying! I lost my voice (which happens all the time since Dane was born?). Dane was also nice enough to have an assplosion that got his clothes all dirty. They asked me how I could not consider it an orthotic when CT's paperwork to the FDA names it as an Cranial Orthosis. I said it was in a separate category than a regular orthotic because it is shaping/molding the head. A foot orthotic simply provides support. I also stated that UHC classified the DOC Band as DME unless someone had an orthotics exclusion and then it was conveniently called an orthotic. I also stated inconsistencies with IRISA and how they are out of compliance. They asked to the WSJ reporters names and phone numbers. My friend said to tell them the WSJ is interested in doing a story on how HMO's pay for plagio treatmet (or don't pay for it) and they are using our case as the news peg (and 's too). They actually are interested in doing a story. They couldn't believe how we were treated. UHC would be smart to take action on this and revise their policies. Bad press in the WSJ can drive their stock price down and cost them a lot more in lost stock revenue than bands/helmet will ever cost them.We'll see how it goes from here. I will find out in 5 days. I have already opened my complaint file with the Department of Insurance. I will take it as far as permitted by law. Dane's mom (DOC Band 2/14)For more plagio info

[Guest guest]

Good job !

It sounds like it went well & you had answers for all their

questions, that's what is important. I really hope they'll realize

they'll be causing more trouble if they again deny you, esp. with

your WSJ friend!

Let us know when you find out.

Debbie Abby's mom DOCgrad

MI

> Well my appeal hearing is over. I have no idea how it went. I was

> suppossed to call dh and conference him in, but of course he didn't

> have his cell phone on. He realized this 5 minutes into the call

> and kept beeping through the call waiting. Boy that was annoying!

> I lost my voice (which happens all the time since Dane was born?).

> Dane was also nice enough to have an assplosion that got his

clothes

> all dirty.

> They asked me how I could not consider it an orthotic when CT's

> paperwork to the FDA names it as an Cranial Orthosis. I said it

was

> in a separate category than a regular orthotic because it is

> shaping/molding the head. A foot orthotic simply provides

support.

> I also stated that UHC classified the DOC Band as DME unless

someone

> had an orthotics exclusion and then it was conveniently called an

> orthotic. I also stated inconsistencies with IRISA and how they

are

> out of compliance.

> They asked to the WSJ reporters names and phone numbers. My friend

> said to tell them the WSJ is interested in doing a story on how

> HMO's pay for plagio treatmet (or don't pay for it) and they are

> using our case as the news peg (and 's too). They actually

> are interested in doing a story. They couldn't believe how we were

> treated. UHC would be smart to take action on this and revise

their

> policies. Bad press in the WSJ can drive their stock price down

and

> cost them a lot more in lost stock revenue than bands/helmet will

> ever cost them.

> We'll see how it goes from here. I will find out in 5 days. I

have

> already opened my complaint file with the Department of Insurance.

I

> will take it as far as permitted by law.

>

> Dane's mom (DOC Band 2/14)

[Guest guest]

Beck -

Would you be able to get the procedure code that it was paid out

under. Orthotics start with an L, so any code other than an " L "

code would help. I am geting all my ducks in a row for our external

appeal with the state (prepare for the worst).

Yeah ! She rolled over already! My kids were slow at that

(5 and 6 months).

> It probably went better than you think you know you have

them shaking

> in their boots with the bead press anyhow-we had UHC and got

coverage but I

> swear it was under the DME rider. Please let us know how it turns

out and let

> me know if there is anything I can do to help you!

> Assplosion- I love it chuckle chuckle!

> beck

[Guest guest]

,

Sounds like you did a really good job - I like the way you stuck it to them.

I will keep my fingers crossed for the decision!

Marci (Mom to )

Oklahoma

[Guest guest]

I am looking-

beck

[Guest guest]

I can just share what was presented at a Asperger Conference

by a psychiatrist. That rispedal was usually prescribed

for short periods of time with young autistic child but

not for long due to weight issues and breast development in boys.

That this psychiatrist was using Abilify with some good results

in some children. Some kids I know though have gained weight on

Abilify too. I guess it depends on the child. Our psychiatrist

would not prescribe Klonopin for my daughter's anxiety

saying that in children under 16 it can increase anxiety.

Have you tried a SSRI like zoloft, prozac? For some reason it

did calm my daughter done a lot. Some kids again are more activated

by SSRI's.

Pam

>

> So we're dealing with a bit of a nightmare. First of all, we're juggling

> medications around. He was taking Risperidone for aggression, etc. and you

> know what, it worked REALLY well. We'd seen huge improvements in so many

> areas. But a big concern was the weight gain. He'd moved into the

> " overweight " BMI, and we weren't comfortable with the rate of gain. So we

> decided to take him off the Risperidone, despite positive results. Sigh.

>

>

>

> We have now put him on Clonidine (anyone have experience?). He hasn't been

> on it for a week yet, and he's still only on the lower dose. goes up to .5

> on Wednesday. We've seen a huge return in the aggressive behavior

>

>

>

> Today at school, he went to the bathroom (unsupervised, because previous to

> this incident, there hadn't been any issues). He said he did his business,

> and went to wash his hands (YAY!). He noticed (haha, so Aspie) that there

> was a screw missing on one of the taps. So he fiddled with the tap, and was

> searching for the screw. A child from grade 1 came into the bathroom (my

> other son's classmate, so knows him). This other child asked

> what he was doing, and said looking for a screw. So the other boy

> went into the stall to do his business. While he was in there, went

> over to leave, and noticed the light switch on the wall, and was about to

> turn it off (while other child was IN the bathroom stall). when other child

> came out. Now, not that I'm making excuses for my boy, but this other boy

> tends to be on the dramatic side (his mother would be the first to tell you

> that lol). He got in 's face (ugh) and said " What were you going to

> do? " .

>

>

>

> At this point, we get a little fuzzy. tells me that he didn't want to

> tell the other boy that he was going to turn off the light, for fear that

> he'd get into trouble. So instead (oh the logic, or lack thereof!) he

> panicked, says he " got scared " , and shoved this other boy into the wall,

> told him " in a yelling voice " to leave him alone, and went back to class.

>

>

>

> Sigh.

>

>

>

> Of course, gee thanks school, the principal had a chat with him about " not

> being mean " and " leaving the taps alone " . (completely USELESS follow up,

> IMO)

>

>

>

> As per our daysheet plan, that behavior resulted in 2 " zeros " For that

> period. 2 zeros means loss of two home priveliges. He did great the rest of

> the day though, and managed to get enough

> " 3's " to move two tokens over in class (so he still gets reinforcement for

> what he did GOOD). This system has really worked VERY well for us. And to be

> honest, since I started this program with the school, has had two

> zeros. Total. Now, in one day, we've gone up to four.

>

>

>

> I am trying to be patient with this new medication, and give it time to

> work. but I have such a hard time when I KNOW things can be better. and now

> we're sliding backwards. Sigh.

>

>

>

> Anyway, let me know if you've had experience with Clonidine, and if it takes

> time to fully work. And thanks for letting me whine

>

>

>

> =)

>