Letter of Medical Necessity

[Guest guest]

Well, I went to pick this up today from my ped...I was

impressed...for a ped that had to be pushed into helping me, he

really gave a great letter. Sounds like CT gave him a basic form to

follow. I thought I'd post the text, if it helps anyone out here:

To Whom It May Concern:

I am writing to you regarding the medical necessity for the DOC

Cranial Remodeling Band. Grant Rxxxxx has been diagnosed with

Positional Plagiocephaly which is a nonsynostotic asymmetry of the

head. Infants with positional plagiocephaly may exhibit complex

multistructural asymmetry affecting the cranial vault, face and skull

base. If left untreated, the infant can have persistent facial

asymmetry, which can affect mandibular mechanics, jaw function, and

orbital alignment. Traditional treatment for plagiocephaly has been

surgery of the cranial vault. As you know, craniofacial surgery is

painful and carries the risks associated with complex surgery. It

requires an extended hospital stay and is very costly.

The DOC Cranial Remodeling Band is a non-invasive outpatient

procedure used to correct abnormal head shapes in infants up to 24

months of age. Anthroporhetric data and clinical observations show

it is effective in achieving complete or near-complete correction of

nonsynostotic plagiocephalic characteristics with no evident relapse

following treatment. It is well tolerated by infants.

The procedure involves making a plaster cast of the infant's head and

custom-creating a band to be worn 23 hours a day. The infant is

monitored on a weekly or biweekly basis. Average treatment length is

4.5 months. An infant may require more than one band; this depends

on the age of the child and the severity of the deformity at the

start of treatment.

Cranial Technologies, Inc. hold the patent for the DOC Cranial

Remodeling Band, which available only through Rehab Designs of

America, formerly COPA in this area. We therefore ask that your

client is not penalized for going out of network.

Sincerely,

XXXX

[Guest guest]

---Great letter!!! Mine was similar but didn't say anything about

possibly needing more then one band! Hope that letter works with

insurance!! Good Luck!~ & Gabby

In Plagiocephaly@y..., " kellysdogs " <kellysdogs@y...> wrote:

> Well, I went to pick this up today from my ped...I was

> impressed...for a ped that had to be pushed into helping me, he

> really gave a great letter. Sounds like CT gave him a basic form

to

> follow. I thought I'd post the text, if it helps anyone out here:

>

> To Whom It May Concern:

>

> I am writing to you regarding the medical necessity for the DOC

> Cranial Remodeling Band. Grant Rxxxxx has been diagnosed with

> Positional Plagiocephaly which is a nonsynostotic asymmetry of the

> head. Infants with positional plagiocephaly may exhibit complex

> multistructural asymmetry affecting the cranial vault, face and

skull

> base. If left untreated, the infant can have persistent facial

> asymmetry, which can affect mandibular mechanics, jaw function, and

> orbital alignment. Traditional treatment for plagiocephaly has

been

> surgery of the cranial vault. As you know, craniofacial surgery is

> painful and carries the risks associated with complex surgery. It

> requires an extended hospital stay and is very costly.

>

> The DOC Cranial Remodeling Band is a non-invasive outpatient

> procedure used to correct abnormal head shapes in infants up to 24

> months of age. Anthroporhetric data and clinical observations show

> it is effective in achieving complete or near-complete correction

of

> nonsynostotic plagiocephalic characteristics with no evident

relapse

> following treatment. It is well tolerated by infants.

>

> The procedure involves making a plaster cast of the infant's head

and

> custom-creating a band to be worn 23 hours a day. The infant is

> monitored on a weekly or biweekly basis. Average treatment length

is

> 4.5 months. An infant may require more than one band; this depends

> on the age of the child and the severity of the deformity at the

> start of treatment.

>

> Cranial Technologies, Inc. hold the patent for the DOC Cranial

> Remodeling Band, which available only through Rehab Designs of

> America, formerly COPA in this area. We therefore ask that your

> client is not penalized for going out of network.

>

> Sincerely,

> XXXX

[Guest guest]

awesome letter thanks for posting it!

beck

[Guest guest]

Great !

Glad that he didn't give you any grief over this too. Now lets hope

it helps & ins. will promptly pay.

Debbie abby's mom DOCGrad

MI

> Well, I went to pick this up today from my ped...I was

> impressed...for a ped that had to be pushed into helping me, he

> really gave a great letter. Sounds like CT gave him a basic form

to

> follow. I thought I'd post the text, if it helps anyone out here:

>

> To Whom It May Concern:

>

> I am writing to you regarding the medical necessity for the DOC

> Cranial Remodeling Band. Grant Rxxxxx has been diagnosed with

> Positional Plagiocephaly which is a nonsynostotic asymmetry of the

> head. Infants with positional plagiocephaly may exhibit complex

> multistructural asymmetry affecting the cranial vault, face and

skull

> base. If left untreated, the infant can have persistent facial

> asymmetry, which can affect mandibular mechanics, jaw function, and

> orbital alignment. Traditional treatment for plagiocephaly has

been

> surgery of the cranial vault. As you know, craniofacial surgery is

> painful and carries the risks associated with complex surgery. It

> requires an extended hospital stay and is very costly.

>

> The DOC Cranial Remodeling Band is a non-invasive outpatient

> procedure used to correct abnormal head shapes in infants up to 24

> months of age. Anthroporhetric data and clinical observations show

> it is effective in achieving complete or near-complete correction

of

> nonsynostotic plagiocephalic characteristics with no evident

relapse

> following treatment. It is well tolerated by infants.

>

> The procedure involves making a plaster cast of the infant's head

and

> custom-creating a band to be worn 23 hours a day. The infant is

> monitored on a weekly or biweekly basis. Average treatment length

is

> 4.5 months. An infant may require more than one band; this depends

> on the age of the child and the severity of the deformity at the

> start of treatment.

>

> Cranial Technologies, Inc. hold the patent for the DOC Cranial

> Remodeling Band, which available only through Rehab Designs of

> America, formerly COPA in this area. We therefore ask that your

> client is not penalized for going out of network.

>

> Sincerely,

> XXXX

[Guest guest]

Excellent letter - thanks for sharing it with the group. That is sure to come

in handy.

Marci (Mom to )

Oklahoma

[Guest guest]

,

That really is an excellent letter! Let's hope it does the trick and

insurance pays up!! Good luckand thanks for sharing!

Niki

Kaylie & Danny (STAR grads)

Phila., PA

> Well, I went to pick this up today from my ped...I was

> impressed...for a ped that had to be pushed into helping me, he

> really gave a great letter. Sounds like CT gave him a basic form

to

> follow. I thought I'd post the text, if it helps anyone out here:

>

> To Whom It May Concern:

>

> I am writing to you regarding the medical necessity for the DOC

> Cranial Remodeling Band. Grant Rxxxxx has been diagnosed with

> Positional Plagiocephaly which is a nonsynostotic asymmetry of the

> head. Infants with positional plagiocephaly may exhibit complex

> multistructural asymmetry affecting the cranial vault, face and

skull

> base. If left untreated, the infant can have persistent facial

> asymmetry, which can affect mandibular mechanics, jaw function, and

> orbital alignment. Traditional treatment for plagiocephaly has

been

> surgery of the cranial vault. As you know, craniofacial surgery is

> painful and carries the risks associated with complex surgery. It

> requires an extended hospital stay and is very costly.

>

> The DOC Cranial Remodeling Band is a non-invasive outpatient

> procedure used to correct abnormal head shapes in infants up to 24

> months of age. Anthroporhetric data and clinical observations show

> it is effective in achieving complete or near-complete correction

of

> nonsynostotic plagiocephalic characteristics with no evident

relapse

> following treatment. It is well tolerated by infants.

>

> The procedure involves making a plaster cast of the infant's head

and

> custom-creating a band to be worn 23 hours a day. The infant is

> monitored on a weekly or biweekly basis. Average treatment length

is

> 4.5 months. An infant may require more than one band; this depends

> on the age of the child and the severity of the deformity at the

> start of treatment.

>

> Cranial Technologies, Inc. hold the patent for the DOC Cranial

> Remodeling Band, which available only through Rehab Designs of

> America, formerly COPA in this area. We therefore ask that your

> client is not penalized for going out of network.

>

> Sincerely,

> XXXX

[Guest guest]

I hope it will help others. I'm pretty sure Rehab Designs (CT authorized clinic) sent my doc a letter to use ...it'a great, though! Hopefully it will help insurance matters here.

, Mom to Grant (9/26/01)

marcisch@... wrote: Excellent letter - thanks for sharing it with the group. That is sure to come in handy.Marci (Mom to )OklahomaFor more plagio info

[Guest guest]

Lesa,

I had saved this post from back in May for someone just like you. Hope it helps.

Gail, Sam and Sara's mom, DOC grads

Letter of Medical Necessity

Well, I went to pick this up today from my ped...I was impressed...for a ped that had to be pushed into helping me, he really gave a great letter. Sounds like CT gave him a basic form to follow. I thought I'd post the text, if it helps anyone out here:To Whom It May Concern:I am writing to you regarding the medical necessity for the DOC Cranial Remodeling Band. Grant Rxxxxx has been diagnosed with Positional Plagiocephaly which is a nonsynostotic asymmetry of the head. Infants with positional plagiocephaly may exhibit complex ultistructural asymmetry affecting the cranial vault, face and skull base. If left untreated, the infant can have persistent facial asymmetry, which can affect mandibular mechanics, jaw function, and orbital alignment. Traditional treatment for plagiocephaly has been surgery of the cranial vault. As you know, craniofacial surgery is painful and carries the risks associated with complex surgery. It requires an extended hospital stay and is very costly.The DOC Cranial Remodeling Band is a non-invasive outpatient procedure used to correct abnormal head shapes in infants up to 24 months of age. Anthroporhetric data and clinical observations show it is effective in achieving complete or near-complete correction of nonsynostotic plagiocephalic characteristics with no evident relapse following treatment. It is well tolerated by infants.The procedure involves making a plaster cast of the infant's head and custom-creating a band to be worn 23 hours a day. The infant is monitored on a weekly or biweekly basis. Average treatment length is 4.5 months. An infant may require more than one band; this depends on the age of the child and the severity of the deformity at the start of treatment.Cranial Technologies, Inc. hold the patent for the DOC Cranial Remodeling Band, which available only through Rehab Designs of America, formerly COPA in this area. We therefore ask that your client is not penalized for going out of network.Sincerely,XXXXFor more plagio info

[Guest guest]

,

Have you already checked out the files section? In the

Files/Insurance Help section, there are at least 2 letters of

medical necessity contributed by group members, and some info in the

file " 1st Step for Insurance " that might help. There may by some

letters of medical neccesity in the folders of group members appeal

packets also in the Files/Insurance help folder.

Would you let us know if this is what you are looking for?

Take care,

Christie (Mom to Repo'd Remy)

> Hello Everyone,

> I was denied for Will's DOC Band by Horizon BC/BS of NJ and

they

> stated it was not medically necessary. My question is what kind

of

> letter of medical necessity did any of your doctors write. My

doctor

> just wrote on a script stating that the " DOC band was medically

> necessary due to tort. " I am finally going to start writing the

appeal

> letter. Any advice or comments would be appreciated. Thanks and

take

> care.

>

>

> Will's(5 months old) Mom in DOC Band for 4 weeks, 4 more weeks to

go:)

[Guest guest]

,

Have you already checked out the files section? In the

Files/Insurance Help section, there are at least 2 letters of

medical necessity contributed by group members, and some info in the

file " 1st Step for Insurance " that might help. There may by some

letters of medical neccesity in the folders of group members appeal

packets also in the Files/Insurance help folder.

Would you let us know if this is what you are looking for?

Take care,

Christie (Mom to Repo'd Remy)

> Hello Everyone,

> I was denied for Will's DOC Band by Horizon BC/BS of NJ and

they

> stated it was not medically necessary. My question is what kind

of

> letter of medical necessity did any of your doctors write. My

doctor

> just wrote on a script stating that the " DOC band was medically

> necessary due to tort. " I am finally going to start writing the

appeal

> letter. Any advice or comments would be appreciated. Thanks and

take

> care.

>

>

> Will's(5 months old) Mom in DOC Band for 4 weeks, 4 more weeks to

go:)

[Guest guest]

Hi ,

Our doctor wrote a great one and it's in the files section if you'd

like to read it. It's the one from Dr. Madsen of Boston's

Children's Hospital. It takes about potential problems if it was

left untreated, etc.

, mom to Hannah, DOCgrad

Cape Cod, Ma

http://hannahsnoggin.typepad.com

> Hello Everyone,

> I was denied for Will's DOC Band by Horizon BC/BS of NJ and

they

> stated it was not medically necessary. My question is what kind

of

> letter of medical necessity did any of your doctors write. My

doctor

> just wrote on a script stating that the " DOC band was medically

> necessary due to tort. " I am finally going to start writing the

appeal

> letter. Any advice or comments would be appreciated. Thanks and

take

> care.

>

>

> Will's(5 months old) Mom in DOC Band for 4 weeks, 4 more weeks to

go:)

[Guest guest]

Hi ,

Our doctor wrote a great one and it's in the files section if you'd

like to read it. It's the one from Dr. Madsen of Boston's

Children's Hospital. It takes about potential problems if it was

left untreated, etc.

, mom to Hannah, DOCgrad

Cape Cod, Ma

http://hannahsnoggin.typepad.com

> Hello Everyone,

> I was denied for Will's DOC Band by Horizon BC/BS of NJ and

they

> stated it was not medically necessary. My question is what kind

of

> letter of medical necessity did any of your doctors write. My

doctor

> just wrote on a script stating that the " DOC band was medically

> necessary due to tort. " I am finally going to start writing the

appeal

> letter. Any advice or comments would be appreciated. Thanks and

take

> care.

>

>

> Will's(5 months old) Mom in DOC Band for 4 weeks, 4 more weeks to

go:)