Guest guest Posted August 3, 2009 Report Share Posted August 3, 2009 Hi Dana, welcome to the group. UHC is notorious for not paying (based on my experience here). You should look in the files section and get some ideas for your appeal - which will probably be needed. As for fixing the neck and the head will follow, that may be true to some extent, but without a helmet/band there will be nothing to help compensate for the fact that part of the head is disproportionately large. The growth might be distributed more evenly in the future, but that won't balance out the existing problem. you can try aggressive repositioning, where you keep her resting on the prominent area as much as possible, but after 6 mo babies are very mobile and this is tough. You will need a prescription to get a band, so you'll have to get your doctor, or a new one to support you. We saw a cranial facial plastic surgeon (referred by our ped) and he wrote the Rx. Also if your baby has torticollis, you should have a referral to a physical therapist to stretch and strengthen the neck. I'm not sure if the chiro gave you exercises to do at home, but those are generally needed. Tort is very common with plagio and one of the big contributors. I haven't heard about vertebrae being out of place on a baby. It might happen too, but I would definitely find out a bit more about tort and see if you need treatment for that. -christine sydney, 3.5 yrs, starband grad > > I am brand new here. My daughter is now 6 1/2 months old. At 4 1/2 months old, a fellow YMCA-er pointed out her plagio to me . . .at the time I knew nothing about it, but that she had a flat spot. But she pointed out the ear assymmetry and from there I researched & learned more. Saw my pediatrician immediately who told me it would round out . . and suggested seh had torticollis. And to do stretches and reposition. AFter a week or two we decided to see a chiropractor who found her 4c neck vertebrae was out of position causing her to prefer her right side. > Since then her neck is doing so much better and we are repositioning, but her head is still misshapen. We have decided ot go forward with the helmet/band, but dont' know what to do first. Terrified of it all, but want ot move quickly and not miss a growth spurt! Also, have United Health Care (Illiniois - Caterpillar) who specifically says orthodics to reshape body parts for cosmetic reasons is not covered. (though I know it's not just cosmetic) How do I go about getting this covered w/o a doctor backing me. btw, the chiro too said I was being hypercritical and it would fix itself. Fix the neck, the head will follow both pediatrican & chiro said. We have also seen a crainiopath and started skull molding, but this is a long slow process, that may or may not work. > Any advice would be great. Can i just go to Cranial Technologies & get it done? Do I need a prescription from my doctor? (if she'll supply one?) I know I need to call my insurance and ask . .but this seems to be a wealth of knowledge. > Thank you, > Dana > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 3, 2009 Report Share Posted August 3, 2009 Dana, My son (7 mo) started his DOC Band at 5.5 months. He's done great...and we're so glad we proceeded with treatment. We had to look for a pediatrician who agreed my son had a problem (the plagio). You might talk to Cranial Tech about the pediatricians who refer to them often. In our case, we knew a family whose daughter had a DOC Band, so we asked who their pediatrician was. Made an appointment and loved her. (We'd had two previous pediatricians who we weren't wild about - and they didn't think the plagio was a problem.) We had our Cranial Tech consult the day before we met the pediatrician who wrote our prescription, which is a little bit out of order, but we wanted to get going with Cranial Tech to find out what they thought and what the timing would be if we moved forward. Thankfully, the pediatrician we saw the next day was in agreement that he needed a band and she wrote the prescription. So it was a quick process after that. We also have United Healthcare, which doesn't have a very good reputation for covering the bands. Our claim was denied, and we were ready for that. Kind of expected that we'd have to appeal. I just submitted my appeal, in fact. We knew we needed to do the band, with or without coverage...so we proceeded without it and I've been working on the appeal for the past couple of weeks. We'll see what happens. I wouldn't wait on the insurance to get settled. If at all possible, get going with treatment as soon as you can and work on the insurance simultaneously. The younger she is when you start the better. And most likely, with UHC, you'll have to appeal. Good luck! Jill Cade's mom (7 mo./DOC Band 6/18/09) Austin > > I am brand new here. My daughter is now 6 1/2 months old. At 4 1/2 months old, a fellow YMCA-er pointed out her plagio to me . . .at the time I knew nothing about it, but that she had a flat spot. But she pointed out the ear assymmetry and from there I researched & learned more. Saw my pediatrician immediately who told me it would round out . . and suggested seh had torticollis. And to do stretches and reposition. AFter a week or two we decided to see a chiropractor who found her 4c neck vertebrae was out of position causing her to prefer her right side. > Since then her neck is doing so much better and we are repositioning, but her head is still misshapen. We have decided ot go forward with the helmet/band, but dont' know what to do first. Terrified of it all, but want ot move quickly and not miss a growth spurt! Also, have United Health Care (Illiniois - Caterpillar) who specifically says orthodics to reshape body parts for cosmetic reasons is not covered. (though I know it's not just cosmetic) How do I go about getting this covered w/o a doctor backing me. btw, the chiro too said I was being hypercritical and it would fix itself. Fix the neck, the head will follow both pediatrican & chiro said. We have also seen a crainiopath and started skull molding, but this is a long slow process, that may or may not work. > Any advice would be great. Can i just go to Cranial Technologies & get it done? Do I need a prescription from my doctor? (if she'll supply one?) I know I need to call my insurance and ask . .but this seems to be a wealth of knowledge. > Thank you, > Dana > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 4, 2009 Report Share Posted August 4, 2009 Ok - quick update . . called CT on monday, they had an appt today!!! must have had a cancellation. Drove 3 hours, got the measurements, etc. they suggest banding, of course, but her cranial assym.is 13 mm. Anyhow, my ped still hasn't returned my call. I spoke with them early mondya morning and told them I was getting measurements. They suggested I see the neurosurgeon first & that's their standard procedure. Nurse said she would call them to see if the CT #s would be enough or not. Never called back. Called agian today, no returned call. ugh. anyhow CT COULD have done the casting today, but nto w/o prescription. So, they sent info to my ped & I am calling her in the am. We are willing to pay out of pocket too, b/c our insurance requires approval after presciption, but before actual order. Review process: 30-60 days. nope Anyhow, prayers tonight that my pediatrician will just sign prescription and we can move ahead. just want ot get it started. though I'm scared to death. > > > > I am brand new here. My daughter is now 6 1/2 months old. At 4 1/2 months old, a fellow YMCA-er pointed out her plagio to me . . .at the time I knew nothing about it, but that she had a flat spot. But she pointed out the ear assymmetry and from there I researched & learned more. Saw my pediatrician immediately who told me it would round out . . and suggested seh had torticollis. And to do stretches and reposition. AFter a week or two we decided to see a chiropractor who found her 4c neck vertebrae was out of position causing her to prefer her right side. > > Since then her neck is doing so much better and we are repositioning, but her head is still misshapen. We have decided ot go forward with the helmet/band, but dont' know what to do first. Terrified of it all, but want ot move quickly and not miss a growth spurt! Also, have United Health Care (Illiniois - Caterpillar) who specifically says orthodics to reshape body parts for cosmetic reasons is not covered. (though I know it's not just cosmetic) How do I go about getting this covered w/o a doctor backing me. btw, the chiro too said I was being hypercritical and it would fix itself. Fix the neck, the head will follow both pediatrican & chiro said. We have also seen a crainiopath and started skull molding, but this is a long slow process, that may or may not work. > > Any advice would be great. Can i just go to Cranial Technologies & get it done? Do I need a prescription from my doctor? (if she'll supply one?) I know I need to call my insurance and ask . .but this seems to be a wealth of knowledge. > > Thank you, > > Dana > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 5, 2009 Report Share Posted August 5, 2009 Great news to report! Things are moving quickly and in teh direction I desire! yeah! My pediatrician is signing hte prescription . . they talked to teh neurology dept and agreed it would be a waste of everyone's time. So we are having her scan done next monday, the 10th at CT. Then we get the band on tht 24th. I'm so nervous about it all, but oh so very relieved. She will be 7 months by the time we get the band, but this is suprisingly sooner than I had originally anticipated. Also, we are submitting to insurance, but are expecting to pay out of pocket and are prepared for that. Stinks, but such is life. We'll fight where we can. I'm just thrilled to be getting Holly started on therapy! Thanks to all for all the information. I'm sure I'll be writing more as we progress down this seemingly scary path. Dana > > > > I am brand new here. My daughter is now 6 1/2 months old. At 4 1/2 months old, a fellow YMCA-er pointed out her plagio to me . . .at the time I knew nothing about it, but that she had a flat spot. But she pointed out the ear assymmetry and from there I researched & learned more. Saw my pediatrician immediately who told me it would round out . . and suggested seh had torticollis. And to do stretches and reposition. AFter a week or two we decided to see a chiropractor who found her 4c neck vertebrae was out of position causing her to prefer her right side. > > Since then her neck is doing so much better and we are repositioning, but her head is still misshapen. We have decided ot go forward with the helmet/band, but dont' know what to do first. Terrified of it all, but want ot move quickly and not miss a growth spurt! Also, have United Health Care (Illiniois - Caterpillar) who specifically says orthodics to reshape body parts for cosmetic reasons is not covered. (though I know it's not just cosmetic) How do I go about getting this covered w/o a doctor backing me. btw, the chiro too said I was being hypercritical and it would fix itself. Fix the neck, the head will follow both pediatrican & chiro said. We have also seen a crainiopath and started skull molding, but this is a long slow process, that may or may not work. > > Any advice would be great. Can i just go to Cranial Technologies & get it done? Do I need a prescription from my doctor? (if she'll supply one?) I know I need to call my insurance and ask . .but this seems to be a wealth of knowledge. > > Thank you, > > Dana > > > Quote Link to comment Share on other sites More sharing options...
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