Guest guest Posted May 2, 2002 Report Share Posted May 2, 2002 Hello Everyone, I am new here my name is Trisha I have 2 ds's on is almost 4 and my baby is 4mos today. I noticed at about 8 weeks that Braeden held his head funny and was getting flat in the back. Low and behold @ his 2 mo appt. the Ped diagnosed Torticollis & then the road began. We had a hard time getting into see anyone because of insurance they didn't have anyone on our policy and finally I found someone. We have been in therapy for about 4 weeks and are noticing changes in his Tort but we can not get his head to make any changes....We went to a Craniofacial specialist and he has prescribed the Doc Bad due to Braeden having Severe deformity w/Plagio & Brach???....Now here is where my problem is really getting bad...We have Cigna PPO and Cranio Tech has said that they are the worst and NEVER pay....and We can not afford the band w/o help. Their payment plan is $600.00 down & $350.00 a month...have any of you dealt w/Cigna PPO on this and do any of you have any advise for me on how to help my Little Angel stay in the new positions he does not like it at all... Thanks to Everyone & I thank God I found this place!!!! Trisha (Drake 4 y/o & Braeden 4 mo. w/tort & plagio) For more plagio info Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 2, 2002 Report Share Posted May 2, 2002 Hi Trisha, I'm sure you have already heard about (Owen's mom) and (Gabby's mom) and their victories over Cigna. I am awaiting a response on my first level appeal (we have Cigna HMO) for coverage of DOC bands for both of my twins. Today I called Cigna just to check on the status and I was given quite a runaround, but they finally acknowleged that they had received it. One thing that told me about after we had already sent in our appeal was a district court ruling against Cigna just a few weeks ago. You can read the ruling at this link... http://laws.findlaw.com/4th/011705p.html. It might help you with some of your arguments in your appeal. Good luck and let me know if you need anything. Gail, Sam and Sara's mom Hello I am New here Hello Everyone, I am new here my name is Trisha I have 2 ds's on is almost 4 and my baby is 4mos today. I noticed at about 8 weeks that Braeden held his head funny and was getting flat in the back. Low and behold @ his 2 mo appt. the Ped diagnosed Torticollis & then the road began. We had a hard time getting into see anyone because of insurance they didn't have anyone on our policy and finally I found someone. We have been in therapy for about 4 weeks and are noticing changes in his Tort but we can not get his head to make any changes....We went to a Craniofacial specialist and he has prescribed the Doc Bad due to Braeden having Severe deformity w/Plagio & Brach???....Now here is where my problem is really getting bad...We have Cigna PPO and Cranio Tech has said that they are the worst and NEVER pay....and We can not afford the band w/o help. Their payment plan is $600.00 down & $350.00 a month...have any of you dealt w/Cigna PPO on this and do any of you have any advise for me on how to help my Little Angel stay in the new positions he does not like it at all... Thanks to Everyone & I thank God I found this place!!!! Trisha (Drake 4 y/o & Braeden 4 mo. w/tort & plagio) For more plagio info Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 3, 2002 Report Share Posted May 3, 2002 Great!! and thanks for the Welcome...Yes I have heard of them both and actaully has been a big help in showing me where to look for things. I was suppose to go to Cranial Tech. today to pick up the appeals packet but my sons school called saying he had a 102 fever, so needless to say I didnt get by. I am so thankful I have found all of you...I dont feel so traped in my feelings anymore...thanks for the link I am going to use it for sure. I did take Braeden to the Ped for his 4 mo check and he said he is going to write a letter for my appeal too he said if they want to play that game he wil...I love him...Thanks again, Trisha Re: Hello I am New here Hi Trisha, I'm sure you have already heard about (Owen's mom) and (Gabby's mom) and their victories over Cigna. I am awaiting a response on my first level appeal (we have Cigna HMO) for coverage of DOC bands for both of my twins. Today I called Cigna just to check on the status and I was given quite a runaround, but they finally acknowleged that they had received it. One thing that told me about after we had already sent in our appeal was a district court ruling against Cigna just a few weeks ago. You can read the ruling at this link... http://laws.findlaw.com/4th/011705p.html <http://laws.findlaw.com/4th/011705p.html> . It might help you with some of your arguments in your appeal. Good luck and let me know if you need anything. Gail, Sam and Sara's mom Hello I am New here Hello Everyone, I am new here my name is Trisha I have 2 ds's on is almost 4 and my baby is 4mos today. I noticed at about 8 weeks that Braeden held his head funny and was getting flat in the back. Low and behold @ his 2 mo appt. the Ped diagnosed Torticollis & then the road began. We had a hard time getting into see anyone because of insurance they didn't have anyone on our policy and finally I found someone. We have been in therapy for about 4 weeks and are noticing changes in his Tort but we can not get his head to make any changes....We went to a Craniofacial specialist and he has prescribed the Doc Bad due to Braeden having Severe deformity w/Plagio & Brach???....Now here is where my problem is really getting bad...We have Cigna PPO and Cranio Tech has said that they are the worst and NEVER pay....and We can not afford the band w/o help. Their payment plan is $600.00 down & $350.00 a month...have any of you dealt w/Cigna PPO on this and do any of you have any advise for me on how to help my Little Angel stay in the new positions he does not like it at all... Thanks to Everyone & I thank God I found this place!!!! Trisha (Drake 4 y/o & Braeden 4 mo. w/tort & plagio) For more plagio info Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 3, 2002 Report Share Posted May 3, 2002 Trisha, Welcome to the group!!! I really feel for you and your insurance problems, it seems there are lots of parents here going through the same garbage- it is really wrong! I can't help you on the appeals process, but I'm sure lots of parents here as well as Marci, one of the moderators, can offer you excellent advice on the process. If that doesn't work- I have heard of parents having fund raisers or talking with the Shriners Club or churches about either raising money or donating it. You never know! As for the torticollis, encouraging supervised tummy time will help strengthen the neck muscles. Make sure your child is trying to use both sides of the body as well, sometimes they tend to only use the favored side and not the tort side. Offer toys to Braeden so that he will try to grab it with his tort side hand as well as the other. Usually they hate tummy time, mirrors or being higher up (on a bed) helps make it more exciting. Check into the group www.torticolliskids for great tips and advice on tort. We used rolled up receiving blankets to prop the head midline. Limit time spent on the back of the head (such as in bouncers, swings, etc.). My son was dx with tort at 2 months and plagio was discovered by 4 months- so we have lots in common If I can help you in anyway, please just ask! Attached is a link to give you some good holds and stretches for the tort. Good luck and please keep us posted! ' Mom Stretches/Holds Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 3, 2002 Report Share Posted May 3, 2002 Trisha, You really are caught between a rock and a hard place. There have been some successful Cigna appealers round here lately and I see that you have already received a reply from one of them. Don't give up just yet - just because they don't like to pay doesn't mean they WON'T pay!! See if your specialist will write a strong letter of medical necessity and if you receive a denial then send the letter in with your appeal as soon as possible. You can also check our " insurance help " section and see some successful letters of appeal. The PT for the tort will help make repositioning a little easier. You might also check out the bookmarks section and there you will find some links to some products that were designed to help with repositioning and tummy time. Best wishes and don't give up that insurance won't cover - they've done it before they can darn well do it again!!! Marci (Mom to ) Oklahoma Quote Link to comment Share on other sites More sharing options...
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