Re: Blue Cross/Blue Shield New Jersey

[Guest guest]

Hi Barbara & welcome to our group!

Let me start by saying you are to be starting your daughter's

treatment at a great younger age! She should achieve great & fast

improvement as she'll be hitting many growth spurts in the months to

come.

Will you be receiving a DOCband made by Cranial Technologies? I know

they have a clinic in NJ so that's what I'm assuming you'll be

receiving. If it is in fact the DOCband, the clinic will let you

begin treatment and will most likely set you up on some sort of

payment plan while you are fighting with your ins.. You should

definitely call the office to see exactly what they do in these

situations. If you do pay for it, then your ins. ends up paying for

it later, Cranial Tech will definitely refund your money to you.

If you are going with a different product, like the STARband or a

locally made helmet, I would imagine they'd offer a similar program.

Again, talk it over with them.

I didn't have BCBS but hopefully someone else with your ins. can

offer some help. Who knows, maybe ins. will come thru for you and

pay without any trouble! Wouldn't that be nice?!

Welcome again to our group. Please stick around and let us know

about your ins. as well as your daughter's plagio & band.

Debbie Abby's mom DOCGrad

MI

> I'm new to this group and just learning about this condition as my

4

> month old daughter requires this treatment. I am waiting for BC/BS

> NJ to advise if they will cover this treatment. I was alerted by

the

> Doctor's office that they have been denying this deaming it

> cosmetic. Has anyone been approved by them? If I'm denied I've

been

> told to appeal. How long does an appeal take? Can I start the

> treatment and pay out of pocket while I'm in appeals and if it's

> approved will they reimburse for what has been paid? I'm sorry for

> so many questions but I am trying to do things correctly. I am

also

> scared of waiting too long....now that I know she needs this done I

> want to take care of it asap.

>

> Thank you

> Barbara

[Guest guest]

Hi Barbara and welcome to the group. You are really fortunate to be

aware of your daughter's condition so early, she should get some

really good rounding. Before you start with treatment, wait for the

denial letter. If you start beforehand, the insurance co. might be

able to deny you on the fact that you started without proper

authorization, or something along those lines. Call the office that

you plan on getting your daughters helmet or band. They should be

able to give you some pointers on how to go about appealing and

setting up a payment plan. If you do pay out of pocket, and then

insurance does come through for you, you will be reimbursed. Good

luck to you, Barbara. Be sure to keep us posted!

Niki

Kaylie & Danny (STAR grads)

Phila., PA

> I'm new to this group and just learning about this condition as my

4

> month old daughter requires this treatment. I am waiting for BC/BS

> NJ to advise if they will cover this treatment. I was alerted by

the

> Doctor's office that they have been denying this deaming it

> cosmetic. Has anyone been approved by them? If I'm denied I've

been

> told to appeal. How long does an appeal take? Can I start the

> treatment and pay out of pocket while I'm in appeals and if it's

> approved will they reimburse for what has been paid? I'm sorry for

> so many questions but I am trying to do things correctly. I am

also

> scared of waiting too long....now that I know she needs this done I

> want to take care of it asap.

>

> Thank you

> Barbara

[Guest guest]

In a message dated 6/11/2002 10:30:02 AM Eastern Daylight Time, catasofia2002@... writes:

I have a consultation with both Cranial Tech and Miami

Childrens Hospital (they use the STARband) this week to gather more

information on each.

Barbara,

Hi and welcome! Just wanted to share that we used CT in Miami and found them to be very caring and edcuated on all points. received about 90-95% correction. Any concerns we had, they were more than happy to help us. Good luck on whatever you decide. I didn't even know Miami Childrens offers the STARband, interesting!

' Mom

[Guest guest]

Thank you Marci, Niki, Debbie, and everybody for their

advice and support. I just spoke to BC/BS NJ and they said that they

do not have the documents requesting pre-determination for my

daughter Sofia. Between the doctors office and myself we sent them

in a total of 5 times last week. On Friday I sent a fedex package

that they received yesterday at 9 a.m. but when I called this morning

they said they had not received any documents on this case. I again

faxed them this a.m. with a copy of the P.O.D. and asked for a

supervisor to return my call (they said she would call within 24

hours).

I'm having another dilema. Should I go with the STARband or DOC

Band? I have a consultation with both Cranial Tech and Miami

Childrens Hospital (they use the STARband) this week to gather more

information on each. Any advise? I'm scared and want to do what is

best for Sofia.

Thank you....I'm glad I was referred to your group. The advise and

emotional support is greatly needed and appreciated.

Barbara (Sofia's mom)

> I'm new to this group and just learning about this condition as my

4

> month old daughter requires this treatment. I am waiting for BC/BS

> NJ to advise if they will cover this treatment. I was alerted by

the

> Doctor's office that they have been denying this deaming it

> cosmetic. Has anyone been approved by them? If I'm denied I've

been

> told to appeal. How long does an appeal take? Can I start the

> treatment and pay out of pocket while I'm in appeals and if it's

> approved will they reimburse for what has been paid? I'm sorry for

> so many questions but I am trying to do things correctly. I am

also

> scared of waiting too long....now that I know she needs this done I

> want to take care of it asap.

>

> Thank you

> Barbara

[Guest guest]

In a message dated 6/11/2002 9:29:52 AM Central Daylight Time, catasofia2002@... writes:

I'm having another dilema. Should I go with the STARband or DOC

Band? I have a consultation with both Cranial Tech and Miami

Childrens Hospital (they use the STARband) this week to gather more

information on each. Any advise? I'm scared and want to do what is

best for Sofia.

Hi Barbara this is a difficult decision but you have to use what is best for you and will work for you a lot of factors play into it time money travel accessibility insurance coverage, etc., they both can be wonderful effective devices in the right hands. Here is a comparison chart that might help you-if you go Star and we have had many wonderful star users make sure you interview the ortho and make sure they have good training and experience. Best of luck with the decision please let us know if we can help in any way!

Beck

Click here: Compare cranial molding orthosis (CMO)

Click here: Questions for the Doctor

[Guest guest]

Hi Barbara,

If the STARband ortho is closer and the cost is less (which I am sure it will

be) then it would be worth it to interview the STARband ortho and see what

kind of experience he/she has. If he/she is experienced and skilled then that

would be an excellent option. If, however, you are not comfortable or

satisfied with the level of experience or skill of the STARband ortho then

DOC would be the way to go. With the STARband it is really all about the

skill level and experience of your ortho.

Good luck and let us know what you decide.

Marci (Mom to )

Oklahoma