Re: Mommy's trailblazing for Grant

[Guest guest]

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I called before we got Dane casted to see if we were covered for the

band. I was told about 7 or 8 times we were covered 80% with an out

of pocket cap of $500. They have denied all of our appeals because

of an orthotics exclusion in our policy. I have names and dates of

those calls so now I have an extra leg to stand on with my external

review! If I was told it was covered by C/S, then it should be

covered!

My point is take down all those names and lock them up. You never

know! I would encourage everyone to call their insurance company

beforehand and ask if it's covered. That way if they say it is and

then deny you, you have an extra pistol in your pocket for the

appeal!

Dane's mom DOC Grad

> >

> > Well, I'm making more progress. After our great appointment at

> Rehab Designs of America (CT), I left a message with my

pediatrician

> that I did not want to wait for the specialist to get things

going.

> I especially felt this way after I called the specialist's nurse

to

> ask her some questions and as soon as she caught wind that I had

> brought Grant in for an evaluation at CT she seemed offended and

put

> off. She said, " Well, we don't use the DOC band. We use a better

> product " about 5 times...pretty much in response to everything I

said

> at that point. Ugh...I don't want this to be a brand

competition...I

> just want to get my son taken care of ASAP. Anyway, I left the

> message with the ped asking if he could go ahead and order the

tests

> to rule out Cranio and then consider writing the rx for the DOC

> band. I also told him I would still be glad to take Grant to the

> specialist appt in a few weeks, but I really wanted to start

> SOMETHING now. Grant's head is growing FAST. It measured 47

> centimeters at CT yesterday (95 percentile!) and Bob at CT said

that

> there are actually some orthotists that won't treat a skull once

it

> measures 48+, because they assume the skull growth will be

> substantially slower from there on. But, we are hoping that since

> Grant's head has always measured large that it will continue along

> that growth rate. We are hoping. But, I just want to get things

> moving and not miss any more significant growth spurts. It

> frustrates me thinking how MUCH it has grown since we started

asking,

> asking, asking our pediatrician about this. ANYWAY I got a call

> from a nurse at my ped's office today telling me to take Grant to

> Children's Mercy for a 'skull series' ? (CAT Skan? MRI? I'm not

> sure?) TOMORROW?! I asked her if he'd write the rx after the

tests

> if they looked fine and she said she thought he was willing to go

> that route, but we'd talk with him after the tests come back.

> Halleluhah Question: Would it be a mistake for me to call my

> health insurance company and ask what their coverage is on DOC

band

> therapy or should I wait and let CT do it if we go that route?

I'm

> curious to know what we're in for, financially.

> >

> > Thanks!

> >

> >

> > , Mom to Grant (born 9/26/01)

> >

> >

> > ---------------------------------

> >