Re: New to group, lots of questions

January 23, 2006

:We had HMO Cigna (in 2000) which originially denied our claim, but upon appeal accepted it. I know a lot of insurance carriers are just out-and-out excluding cranial banding, but feel that they have no right to make this blanket exclusion without knowing the medical circumstances. We had to travel to Chicago (from Cincinnati) to Cranial Technologies, because my son's head shape could only be corrected with a DOC band (he had a very long and narrow shape). His headshape was caused by in utero constriction (breech) -- which I think made a difference in our appeal because we could call it a congential defect. They denied us on three things -- out of network, medical necessity, and repositioning, which we fought -- using pictures to show how we repositioned, and pictures of how his headshape did not change after 3 months of age, and of course a letter of medical neccessity from a specialist.

Cranial Technologies is an excellent company, and the casting is not bad (we did a before cast and after cast). Quinn was about 6 months old when we started if I remember correctly. If you have any questions I'd be happy to help -- tnt@...Kind Regards. (aka "Kali")mom to Quinn, born 11/19/99 -- DOC band graduate for scaphocephalic head shape 10/00brief bio and pix here http://www.cappskids.org/CAPPSPlagioKidQuinn.htm >------- Original Message ------->From : stauntoncas[mailto:stauntoncas@...]>Sent : 1/23/2006 11:24:24 AM>To : Plagiocephaly >Cc : >Subject : RE: New to group, lots of questions>>Hello, I have 7 month old twins, my twin A, Se

amus has what I thought was mild torticollis, and susequently plagiocephaly. I sort of insisted to my pediatrician at his six month check up that I was worried that his ears were off, and should he be looked at by a specialist, and he relented and referred me to Yale in CT. I saw a doctor there and they recommended a cranial orthotic. After looking at the brochures they gave me and further inspection of his face, I think that he could benefit from it. Unfortunately our insurance (Cigna HMO, of CT) doesnt cover cranial banding. We will have to pay for this out of pocket. The clinic referred us to ""Cranial technologies"" in Clinton CT who specialize in the DOC band. The cost there is $3000. The pro's to this is that we live in Clinton so its convenient for follow ups, and they are suppose to be the ""best"" in this area. The cons are the price, and they cast for fittings which looks horrific. After a little research, I a

lso found that Hanger also does cranial banding. I called them and they can do it for around $1700, and they do laser fitting, no casting involved. It will be about a 20 mile ride to the office, but that really doesnt bother me. Obviously I want to do what is best for my child, but is there really any difference between the two? Anyone use Hanger and regret it? I plan of fighting the insurance company about this, but I think that will be an uphill battle, and we have to assume at this point that we will be paying for it out of pocket. Any insight anyone has will be appreciated. ThanksFor more plagio info

January 23, 2006

:We had HMO Cigna (in 2000) which originially denied our claim, but upon appeal accepted it. I know a lot of insurance carriers are just out-and-out excluding cranial banding, but feel that they have no right to make this blanket exclusion without knowing the medical circumstances. We had to travel to Chicago (from Cincinnati) to Cranial Technologies, because my son's head shape could only be corrected with a DOC band (he had a very long and narrow shape). His headshape was caused by in utero constriction (breech) -- which I think made a difference in our appeal because we could call it a congential defect. They denied us on three things -- out of network, medical necessity, and repositioning, which we fought -- using pictures to show how we repositioned, and pictures of how his headshape did not change after 3 months of age, and of course a letter of medical neccessity from a specialist.

Cranial Technologies is an excellent company, and the casting is not bad (we did a before cast and after cast). Quinn was about 6 months old when we started if I remember correctly. If you have any questions I'd be happy to help -- tnt@...Kind Regards. (aka "Kali")mom to Quinn, born 11/19/99 -- DOC band graduate for scaphocephalic head shape 10/00brief bio and pix here http://www.cappskids.org/CAPPSPlagioKidQuinn.htm >------- Original Message ------->From : stauntoncas[mailto:stauntoncas@...]>Sent : 1/23/2006 11:24:24 AM>To : Plagiocephaly >Cc : >Subject : RE: New to group, lots of questions>>Hello, I have 7 month old twins, my twin A, Se

amus has what I thought was mild torticollis, and susequently plagiocephaly. I sort of insisted to my pediatrician at his six month check up that I was worried that his ears were off, and should he be looked at by a specialist, and he relented and referred me to Yale in CT. I saw a doctor there and they recommended a cranial orthotic. After looking at the brochures they gave me and further inspection of his face, I think that he could benefit from it. Unfortunately our insurance (Cigna HMO, of CT) doesnt cover cranial banding. We will have to pay for this out of pocket. The clinic referred us to ""Cranial technologies"" in Clinton CT who specialize in the DOC band. The cost there is $3000. The pro's to this is that we live in Clinton so its convenient for follow ups, and they are suppose to be the ""best"" in this area. The cons are the price, and they cast for fittings which looks horrific. After a little research, I a

lso found that Hanger also does cranial banding. I called them and they can do it for around $1700, and they do laser fitting, no casting involved. It will be about a 20 mile ride to the office, but that really doesnt bother me. Obviously I want to do what is best for my child, but is there really any difference between the two? Anyone use Hanger and regret it? I plan of fighting the insurance company about this, but I think that will be an uphill battle, and we have to assume at this point that we will be paying for it out of pocket. Any insight anyone has will be appreciated. ThanksFor more plagio info

January 23, 2006

Hi,

I havent been answering too many emails..but I read yours and saw you live

in CT...and so do I. I have a 9 mo old son who had positional plagio/brachio

with mild tort....We saw the doctor at Yale when he was 15 weeks old, they

wanted us to wait 6 weeks and go back, so we did and I insisted on banding

him and he said OK...have you gone to CT in Clinton for a free consult? It

may be worth it for you....the casting really was not bad at all, 10

minutes...goes quick, they dont get hurt, just scared. We went through it

twice because we did the exit casting too. My son had good correction, wish

it was better, we could have went for a second band, but my husband and I

wanted to put it behind us, my son wore it for 11 weeks, ( from about 5 1/2

mos to 8 mos or so). I dont know much about Hanger, but wanted to give you

my opinion for DOC band esp since I went to the same place you would be. I

still havent had the chance to post exit pictures....but my son is under the

plagio kids...Dylan .......Carol ( mom to Dylan, now 9 mos, DOC band

grad on 12/16/05)

New to group, lots of questions

> Hello, I have 7 month old twins, my twin A, Seamus has what I

> thought was mild torticollis, and susequently plagiocephaly. I sort

> of insisted to my pediatrician at his six month check up that I was

> worried that his ears were off, and should he be looked at by a

> specialist, and he relented and referred me to Yale in CT. I saw a

> doctor there and they recommended a cranial orthotic. After looking

> at the brochures they gave me and further inspection of his face, I

> think that he could benefit from it. Unfortunately our insurance

> (Cigna HMO, of CT) doesnt cover cranial banding. We will have to

> pay for this out of pocket. The clinic referred us to " Cranial

> technologies " in Clinton CT who specialize in the DOC band. The

> cost there is $3000. The pro's to this is that we live in Clinton

> so its convenient for follow ups, and they are suppose to be

> the " best " in this area. The cons are the price, and they cast for

> fittings which looks horrific. After a little research, I also

> found that Hanger also does cranial banding. I called them and they

> can do it for around $1700, and they do laser fitting, no casting

> involved. It will be about a 20 mile ride to the office, but that

> really doesnt bother me. Obviously I want to do what is best for my

> child, but is there really any difference between the two? Anyone

> use Hanger and regret it? I plan of fighting the insurance company

> about this, but I think that will be an uphill battle, and we have

> to assume at this point that we will be paying for it out of

> pocket. Any insight anyone has will be appreciated. Thanks

>

> For more plagio info

January 23, 2006