Guest guest Posted December 24, 2005 Report Share Posted December 24, 2005 The biggest thing that your insurance company looks @ is the what we call the (L code). ie: L3150 x1 L3208 x2 L2780 X 1. If the Orthotist is using differnt codes then the normal, then they might not pay for certain things that deal with the shoes and bar together. Tim H. CO PTA www.clubfootdesigns.com Marcia wrote: We didn't go to Iowa so didn't deal with this. I've read about others who did though. I think that if you can show your insurance company that the Ponseti method is superior to ther methods and that there are no practicing dr.s in your area that follow the Ponseti protocol then you MAY be able to get it covered. We did have issues with getting the shoes/bar covered and after several phone calls we were able to do it. I think you can file an appeal and that is how you would explain the difference in treatments, etc. Maybe if you can point out that Ponseti treatment is better financially long-term that might help. They would have to pay for hospital visits, surgery, etc. if you don't go the Ponseti route. Good luck! Marcia Getting around insurance... I posted this in another thread but realized it is misplaced. I am reposting it here so as to get more visibility. " I am working on getting things lined up for our trip. We checked with our insurance and they will NOT cover any of the costs (~$5,000 out of pocket). Dr. Ponseti has stated that some people have fought their insurance on this and had success. Anyone have a anecdotal stories to share? -Salem, and Craig <<< finally got the order right p.s.- We are doing it anyway, but if the insurance will pay, ... " --- Salem, and Craig + Claire (who isn't in school and is making the trip with us)::: We are in Laramie, Wyoming for the night... Quote Link to comment Share on other sites More sharing options...
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