Re: New to Group - Decisions to Make and Logistics to Coordinate

[Guest guest]

Welcome to the group. We had very good results from a starband, but

we were in CA. In Conn I know Cranial Technologies has a great

reputation. Many parents travel several hours to go there.

Cranial Technologies, Inc.

252 E. Main St. (Route) 1

Clinton, CT 06413

Phone: 860-664-0587

Toll Free: 866-664-0587

Fax: 860-664-0374

Hopefully someone else will reply about the starband locations you've

mentioned. Let us know what you decide and how your baby does in a band.

-christine

sydney 2 yrs starband grad

>

> Hi Everyone,

>

> We are new to the group and are planning to band our son as soon as

> we can figure out where to go. I am trying to find out if anyone

> has ever had anexperience with the Starband from the orthotists at

> WestConn Orthopedics (also known through NEOPs).

>

> We were referred from a ped neurosurgeon in New Haven to Cranio

> Tech, only to find out later that the good ole insurance considers

> them out of network, but at least they will pay if we go with an in-

> network provider. The insurance referred us to either Hanger in

> Albany or to WestConn Orthopedics in Danbury, CT. We went to

> WestConn for a consult today and I have mixed feelings about them.

> Anyone use them?

>

> On another note - anyone ever have a specialist refuse to write a

> prescription to an alternative type of band? The New Haven

> specialist even wrote a letter to CT/insurance company stating that

> there could be " no substitutions " to which the insurance company

> denied the claim. However, we are without a prescription right

> now.... trying to get one from his general pediatrician, but they

> are hesitant. Ugh!

>

> Thanks!

>

>

>

[Guest guest]

,

I am fairly new to the group as well and am going through almost

the exact same thing at the exact same place. My 9 mo. son has an

orthopedic surgeon for other issues but she wrote to scrip for " DOC

Band " , my insurance (Empire BC/BS) said NO WAY!! We got the exact

same response that you did. The sent us to neops in Danbury. We did

the casting there and get our starband next week. The same day we

casted our ortho called us, the insurance had called her for a new

scrip. She had an abosolute fit, I told her that it was starband or

nothing because I can't pay out of pocket for this and I would have

to with DOC band. We kind of figured this would happen and had

planned to just go back to our neuro and get the scrip from him. In

the end the surgeon relenrd and sent the papers we needed but not

with out a very harsh warning and her very strong opinion on the

subject. For all I've read here I decided that the Starband would be

fine for us to use.They were very nice at neops and made things very

easy going and comfortable for my son. There weren't many tears

through the casting appointment and they were very helpful with in

speaking with my insurance. We get banded next Tuesday. Good luck in

whatever you end up doing, you will find so many wonderful parents

here and so much good information.

--

>

> Hi Everyone,

>

> We are new to the group and are planning to band our son as soon as

> we can figure out where to go. I am trying to find out if anyone

> has ever had anexperience with the Starband from the orthotists at

> WestConn Orthopedics (also known through NEOPs).

>

> We were referred from a ped neurosurgeon in New Haven to Cranio

> Tech, only to find out later that the good ole insurance considers

> them out of network, but at least they will pay if we go with an in-

> network provider. The insurance referred us to either Hanger in

> Albany or to WestConn Orthopedics in Danbury, CT. We went to

> WestConn for a consult today and I have mixed feelings about them.

> Anyone use them?

>

> On another note - anyone ever have a specialist refuse to write a

> prescription to an alternative type of band? The New Haven

> specialist even wrote a letter to CT/insurance company stating that

> there could be " no substitutions " to which the insurance company

> denied the claim. However, we are without a prescription right

> now.... trying to get one from his general pediatrician, but they

> are hesitant. Ugh!

>

> Thanks!

>

>

>

[Guest guest]

The starband should work well for you both -- it's the experience of the orthotist that is usually the culprit with a poor fit. However I do have to say that it is *extremely* rare to get buy-in from a specialist in the first place for a molding device (most see the situation as "does it need surgery or does it not" and tend to discount/blow off molding therapy, usually without much bedside manner. That two specialists are "pro" molding device therapy, and have a specific one that they prefer is quite amazing. I've been in and out of this group since 2000 -- and I know some doctors recommend specific molding devices from time to time (usually when it's affiliated with their hospital, but not always), but truly, it's usually parents who are pushing to get any type of prescription for a molding device, and being told "don't worry about it, it will fix itself, etc." and the specialist discounting all molding therapy. nbsp;I certainly understand the insurance dilemma, and am glad that you are able to find a provider that insurance approves. This would never happen, but if either of those doctors could write a position paper stating the difference in their eyes between molding devices, just on purely medical and scientific data, especially if they aren't affiliated with any one provider, that would go a long way for insurance companies to recognize multiple providers (it's not like StarBand and DOC are so different in cost, after all).Take care mom to Quinn, born 11/99, DOCband grad for scaphocephalic (long and narrow) headshape 10/00>------- Original Message ------->From : detlefs5[mailto:detlefs5@...]>Sent : 4/8/2008 6:29:07 AM>To : Plagiocephaly >Cc : >Subject : RE: Re: New to Group - Decisio

ns to Make and Logistics to Coordinate>>, I am fairly new to the group as well and am going through almost the exact same thing at the exact same place. My 9 mo. son has an orthopedic surgeon for other issues but she wrote to scrip for "DOC Band", my insurance (Empire BC/BS) said NO WAY!! We got the exact same response that you did. The sent us to neops in Danbury. We did the casting there and get our starband next week. The same day we casted our ortho called us, the insurance had called her for a new scrip. She had an abosolute fit, I told her that it was starband or nothing because I can't pay out of pocket for this and I would have to with DOC band. We kind of figured this would happen and had planned to just go back to our neuro and get the scrip from him. In the end the surgeon relenrd and sent the papers we needed but not with out a very harsh warning and her very strong opinion on the sub

ject. For all I've read here I decided that the Starband would be fine for us to use.They were very nice at neops and made things very easy going and comfortable for my son. There weren't many tears through the casting appointment and they were very helpful with in speaking with my insurance. We get banded next Tuesday. Good luck in whatever you end up doing, you will find so many wonderful parents here and so much good information. -->> Hi Everyone, > > We are new to the group and are planning to band our son as soon as > we can figure out where to go. I am trying to find out if anyone > has ever had anexperience with the Starband from the orthotists at > WestConn Orthopedics (also known through NEOPs). > > We were referred from a ped neurosurgeon in New Haven to Cranio > Tech, only to find out lat

er that the good ole insurance considers > them out of network, but at least they will pay if we go with an in-> network provider. The insurance referred us to either Hanger in > Albany or to WestConn Orthopedics in Danbury, CT. We went to > WestConn for a consult today and I have mixed feelings about them. > Anyone use them? > > On another note - anyone ever have a specialist refuse to write a > prescription to an alternative type of band? The New Haven > specialist even wrote a letter to CT/insurance company stating that > there could be "no substitutions" to which the insurance company > denied the claim. However, we are without a prescription right > now.... trying to get one from his general pediatrician, but they > are hesitant. Ugh! > > Thanks! > > >------------------------------------For more plagio info, go to ww

w.plagiocephaly.org/support

[Guest guest]

Thanks everyone for the great responses.

In response to the strangeness of the specificity of the specialists

prescription, I am surprised to learn that more people had not

encountered this. Our doctor was quite clear in his follow up

letter that it was a DOC band made by Cranial Tech that he had most

experience with and most comfortable for his patients. They will not

write me a prescription for another location. I have a call into my

general pediatrician to see if they would write script for another

provider and they called the specialist - I am hoping to hear today.

Meanwhile I am starting through the first prior authorization

rejection from my insurance. The letter they wrote to me states

that since they are out of network they are denying authorization,

yet when I called today the customer service rep said they denied it

based upon medical necessity... weird. They also said they would

not discuss the details ofthe rejection with me, that my prescribing

doctor needed to call them. As if our Pediatric neurosurgeon has

all the time in the world to discuss this one topic with an

insurance company of all places!

Anyway - thanks for the responses. We are still deciding. Will

keep everyone posted who wants to read!

>

> Hi Everyone,

>

> We are new to the group and are planning to band our son as soon

as

> we can figure out where to go. I am trying to find out if anyone

> has ever had anexperience with the Starband from the orthotists at

> WestConn Orthopedics (also known through NEOPs).

>

> We were referred from a ped neurosurgeon in New Haven to Cranio

> Tech, only to find out later that the good ole insurance considers

> them out of network, but at least they will pay if we go with an

in-

> network provider. The insurance referred us to either Hanger in

> Albany or to WestConn Orthopedics in Danbury, CT. We went to

> WestConn for a consult today and I have mixed feelings about them.

> Anyone use them?

>

> On another note - anyone ever have a specialist refuse to write a

> prescription to an alternative type of band? The New Haven

> specialist even wrote a letter to CT/insurance company stating

that

> there could be " no substitutions " to which the insurance company

> denied the claim. However, we are without a prescription right

> now.... trying to get one from his general pediatrician, but they

> are hesitant. Ugh!

>

> Thanks!

>

>

>

[Guest guest]

Cigna made our son's neurosurgeon call them -- and it took 4 weeks for coordination of this phone call to actually occur (because it wasn't the neuro who arranged the calls, it was his administrative assistant, and she didn't like being on hold). Cigna wouldn't take the letter of necessity without the phone call - then had it faxed to them in the course of the phone call and denied it anyway. They gave us three reasons of denial in the denial letter, but we addressed each point, and provided pictures, documentation, etc. and eventually did get reimbursement after we paid out of pocket. Good luck with everything!>------- Original Message ------->From : alp_vt[mailto:alp_vt@...]>Sent : 4/8/2008 11:33:07 AM>To : Plagiocephaly >Cc : >Subject : RE: [Plag

io] Re: New to Group - Decisions to Make and Logistics to Coordinate>>Thanks everyone for the great responses. In response to the strangeness of the specificity of the specialists prescription, I am surprised to learn that more people had not encountered this. Our doctor was quite clear in his follow up letter that it was a DOC band made by Cranial Tech that he had most experience with and most comfortable for his patients. They will not write me a prescription for another location. I have a call into my general pediatrician to see if they would write script for another provider and they called the specialist - I am hoping to hear today. Meanwhile I am starting through the first prior authorization rejection from my insurance. The letter they wrote to me states that since they are out of network they are denying authorization, yet when I called today the customer service rep said they denied it based u

pon medical necessity... weird. They also said they would not discuss the details ofthe rejection with me, that my prescribing doctor needed to call them. As if our Pediatric neurosurgeon has all the time in the world to discuss this one topic with an insurance company of all places! Anyway - thanks for the responses. We are still deciding. Will keep everyone posted who wants to read! >> Hi Everyone, > > We are new to the group and are planning to band our son as soon as > we can figure out where to go. I am trying to find out if anyone > has ever had anexperience with the Starband from the orthotists at > WestConn Orthopedics (also known through NEOPs). > > We were referred from a ped neurosurgeon in New Haven to Cranio > Tech, only to find out later that the good ole insurance considers > them out of network, but at least they will pay if we go with an in-> network provider. The insurance referred us to either Hanger in > Albany or to WestConn Orthopedics in Danbury, CT. We went to > WestConn for a consult today and I have mixed feelings about them. > Anyone use them? > > On another note - anyone ever have a specialist refuse to write a > prescription to an alternative type of band? The New Haven > specialist even wrote a letter to CT/insurance company stating that > there could be "no substitutions" to which the insurance company > denied the claim. However, we are without a prescription right > now.... trying to get one from his general pediatrician, but they > are hesitant. Ugh! > > Thanks! > > >------------------------------------For more plagio info, go to www.plagiocephaly.org/sup

port