We're getting casted tomorrow!

[Guest guest]

Hi all,

It's been awhile since I've posted but I've read most posts everyday

just trying to keep up with what's going on with everybody. Last time I

posted was when we found out that CCN/Mountain States Administrative

Services denied the coverage of the Docband for Mackenzie. Actually, I

guess I should say that it was the Precertification Dept/Managed Care

that denied us. We found out that CCN will probably be overriding the

denial based on the appeal that we sent in. However, even if they don't

override the appeal, CCN will still be paying 70% of the cost of the

band! I'm not sure exactly how this all works but if you don't follow

the precert procedure the benefit is only reduced by 10% so instead of

80% paid, they will definitely pay the 70%! This is even stated in our

benefits booklet! I guess another baby just went through this with CCN

and successfully won their appeal so our representative is now familiar

with the band, the diagnosis that accompanies it and how it actually

works! So, we'll either be paying $600 or $900 depending on the outcome

of the appeal. Our rep definitely said not to wait to get the appeal

approval especially since Mackenzie is almost 10 months old but to go

ahead and do the casting and bill CCN. CT here in Phoenix will just put

us on the payment plan and we'll pay the $600 tomorrow and pay the

remaining $300 when/if it gets billed to us. I don't know how we got so

lucky in having this particular insurance company but let me tell you,

I'm thrilled we do especially after reading all of the trouble that most

people have!

Now starts the process of the casting & fittings! I am definitely not

looking forward to tomorrow as Mackenzie does not like to be held down

for just diaper changes, much less a casting of her head! But my

husband, , is taking time of off work so that he can be there with

us for which I'm really glad. I'm going to follow all of the suggestions

that I've found here and hopefully, it will just be over as soon as

possible. I will let you all know how it goes and I will post pics of

Mackenzie with the band once it arrives.

Thank you all for so much information and support through the postings

on this board!

(mom to Mackenzie)

Phoenix, AZ

[Guest guest]

,

Sooooo glad to hear that the band will be covered - this is GREAT news!! The

casting will be quick and painless for McKenzie - it is usually more painful for

the parents!! It's great the hubby will be going along and that will certainly

make the whole thing more bearable.

Good luck and let us know how it goes!

Marci (Mom to )

oklahoma

[Guest guest]

,

Good luck today at the casting!!! It's really the hardest part of the whole

process, and luckily its over in literally 10 minutes!! Please let us know

how it went!

' Mom