Re: New to the group- still debating DOCband

[Guest guest]

Welcome to the group. To be honest, I can't see any reason not to band. It is

really much easier than you think, and it works. If you don't band he may

improve, and then again, he may not. Also since he has a combo of brachy and

plagio and is in the moderate category I would band. If it were one or the other

and mild, I might consider skipping the band. As for insurance however, you

might have a difficult time. I would file an appeal, but not sure if you will

succeed. We were lucky that our band was covered without an appeal.

-christine

sydney, 4 yrs, starband grad

>

> Hi,

> I am new to the group. My 7month old son is scheduled on Monday at

Cranialtech to be sized for a DOCband. I am still debating if this is the right

decision. Just wondering if anyone has opted NOT to do the band and if you have

seen postive results?? He has moderate plagiocephaly and brachycephaly but his

facial symmetry is very close to normal.

>

> Also, and advice on getting treatment covered by insurance? I have Cigna and

cranial orthotics are a specific exclusion in my policy.

>

> Thanks in advance for your help. So excited to have found this support group!

>

>

>

[Guest guest]

, I totally agree with . Our plastic surgeon was very open and

said the same-- the 'wait-and-see' may work but for certain the band/helmet

works.

The fear before making the decision is the worst part of this entire experience.

This group was invaluable to help deal with it.

Good luck!

Tracey

> >

> > Hi,

> > I am new to the group. My 7month old son is scheduled on Monday at

Cranialtech to be sized for a DOCband. I am still debating if this is the right

decision. Just wondering if anyone has opted NOT to do the band and if you have

seen postive results?? He has moderate plagiocephaly and brachycephaly but his

facial symmetry is very close to normal.

> >

> > Also, and advice on getting treatment covered by insurance? I have Cigna and

cranial orthotics are a specific exclusion in my policy.

> >

> > Thanks in advance for your help. So excited to have found this support

group!

> >

> >

> >

>

[Guest guest]

We have Cigna insurance and they told us they had a specific exclusion for

cranial orthotics initially. We appealed to by husbands HR department and in the

and they decided it was a mistake. They did have pretty high standards to prove

plagiocephally - at least 12 mm asymmetry I think. Not sure what they require

for Brachy.

Even if they turn you down it it worth appealing - and I think there are some

letters online you can use if you need to appeal to the insurance company.

One of my daughters has untreated plagio (7mm) which we found at 9 months. We

got her a STAR scan at 12 months and she is the same level of asymmetry. She has

only a little facial asymmetry and pretty much looks fine.

My other daughter had 15mm asymmetry and has had a Hanger and a STAR band and is

now down to 4.7mm asymmetry. She still has some ear & facial asymmetry - which

the cranial facial surgeon expects to improve with time, but her head shape is

looking much better.

I would recommend going with the band if you are on the fence as it is not

something you can do when they are older - even if it was not covered by

insurance. (we had to pay got the second band).

Hoep that helps!

>

> Hi,

> I am new to the group. My 7month old son is scheduled on Monday at

Cranialtech to be sized for a DOCband. I am still debating if this is the right

decision. Just wondering if anyone has opted NOT to do the band and if you have

seen postive results?? He has moderate plagiocephaly and brachycephaly but his

facial symmetry is very close to normal.

>

> Also, and advice on getting treatment covered by insurance? I have Cigna and

cranial orthotics are a specific exclusion in my policy.

>

> Thanks in advance for your help. So excited to have found this support group!

>

>

>

[Guest guest]

Thanks so much for the response and helpful info! Just out of curiosity when

you refer to 12 mm asymmetry what exactly does that measure? I have the numbers

from cranial tech- my sons Cranial Vault Asymmetry is 5mm and Mid Face Assymetry

is 1mm and skull-base asymmetry is 0. His cranial index is 105mm with a 6.3

standard deviation.

I am more than willing to pay out of pocket if this is the best course of

treatment for my child, just not sure it is " necessary " . The cranial facial

plastic surgeon I saw said the decision is totally up to me but I may be better

off just putting the $3000 in his 529plan!! I just wish it was covered so I

could take that factor out of the decision:)

> >

> > Hi,

> > I am new to the group. My 7month old son is scheduled on Monday at

Cranialtech to be sized for a DOCband. I am still debating if this is the right

decision. Just wondering if anyone has opted NOT to do the band and if you have

seen postive results?? He has moderate plagiocephaly and brachycephaly but his

facial symmetry is very close to normal.

> >

> > Also, and advice on getting treatment covered by insurance? I have Cigna and

cranial orthotics are a specific exclusion in my policy.

> >

> > Thanks in advance for your help. So excited to have found this support

group!

> >

> >

> >

>

[Guest guest]

I'm not as familiar with the brachy #s, but his plagio humbers are mild. My

understanding is that a CVA of 0-3 is a normal range, so I would think that 5 mm

there is mild. Did they tell you that 5 mm CVA was moderate for plaio? A lot

of parents END with 5 mm after a band and are satisfied, particularly if they

start up in the severe range. The skull base asymmetry measurement is where ear

alignment comes in, so a 0 mm measurement there would indicate that his ears

aren't " off " as many babies are who have plagio.

I'm sure one of the other " brachy moms " will explain those numbers for you, and

some of the other plagio moms can do a better job on detailed explanations of

those numbers than I have here as well. Not knowing about the brachy side of

it, if my child had those numbers for plagio and no brachy issue, I'm not

totally sure whether I'd band; however, if you do, you're likely to get down

into the normal range really quickly, especially at 7 months old (remember, I'm

just addressing the plagio).

There's not much of a downside to the band, in my mind, other than the cost, in

cases like yours and mine where insurance doesn't cover it. We have United

Healthcare and also have a written exclusion in our policy for cranial banding

and were therefore denied. I'm not sure whether we'll appeal or not--haven't

heard of any successful appeals in the case of an exclusion, but maybe it's

worth trying. In the meantime we've paid out of pocket for our DOCband so we

could get going. We also tried the route of checking with our employer's HR rep

who handles the insurance. She had the company's insurance " advocate " (I had no

idea companies hired such people) check with United and all they really did was

confirm the exclusion and say we could appeal if we wanted.

> > >

> > > Hi,

> > > I am new to the group. My 7month old son is scheduled on Monday at

Cranialtech to be sized for a DOCband. I am still debating if this is the right

decision. Just wondering if anyone has opted NOT to do the band and if you have

seen postive results?? He has moderate plagiocephaly and brachycephaly but his

facial symmetry is very close to normal.

> > >

> > > Also, and advice on getting treatment covered by insurance? I have Cigna

and cranial orthotics are a specific exclusion in my policy.

> > >

> > > Thanks in advance for your help. So excited to have found this support

group!

> > >

> > >

> > >

> >

>

[Guest guest]

Hello,

My daughter is almost six months old and she has brachycephaly.

We went for an evaluation at Cranial Technologies a few weeks ago.

We are going to CT on Tuesday for her 3D imaging for her doc band.

Since the evaluation, I have been trying to educate myself on

brachycephaly as well as trying to understand what our insurance will and will

not cover.

In my research, I have learned that there is a New Jersey Mandate on Prosthetic

and Orthotic devices. Basically, this means even if your insurance does not

normally cover a helmet/band(and even if they have an exclusion in your

policy)they are still obligated to follow this New Jersey Mandate as long as

they continue to offer Health Care Insurance in New Jersey.

After calling United Health Care and discussing this New Jersey mandate, I was

told that they will cover the helmet and treatment at Cranial Technologies at

our out of network rate (70%) and after our deductible has been met. I believe

you need to ask your healthcare provider to look under the billing code of S1040

to get the information on this mandate.

Hope this helps!

> > >

> > > Hi,

> > > I am new to the group. My 7month old son is scheduled on Monday at

Cranialtech to be sized for a DOCband. I am still debating if this is the right

decision. Just wondering if anyone has opted NOT to do the band and if you have

seen postive results?? He has moderate plagiocephaly and brachycephaly but his

facial symmetry is very close to normal.

> > >

> > > Also, and advice on getting treatment covered by insurance? I have Cigna

and cranial orthotics are a specific exclusion in my policy.

> > >

> > > Thanks in advance for your help. So excited to have found this support

group!

> > >

> > >

> > >

> >

>

[Guest guest]

For the brachy number, you probably mean 105 percent since this is measured in percents rather than mm. That is a pretty severe number and I definately would band with that number. If you are correct, you need to understand that "normal" is in the low 80's. My daughter was banded at 95 percent. Most orthos recommend banding at anything over 90 percent.

, mom to , 2.5 years

STARband grad May 2009

Chiro and CST

land

Re: New to the group- still debating DOCband

I'm not as familiar with the brachy #s, but his plagio humbers are mild. My understanding is that a CVA of 0-3 is a normal range, so I would think that 5 mm there is mild. Did they tell you that 5 mm CVA was moderate for plaio? A lot of parents END with 5 mm after a band and are satisfied, particularly if they start up in the severe range. The skull base asymmetry measurement is where ear alignment comes in, so a 0 mm measurement there would indicate that his ears aren't "off" as many babies are who have plagio. I'm sure one of the other "brachy moms" will explain those numbers for you, and some of the other plagio moms can do a better job on detailed explanations of those numbers than I have here as well. Not knowing about the brachy side of it, if my child had those numbers for plagio and no brachy issue, I'm not totally sure whether I'd band; however, if you do, you're likely to get down into the normal range really quickly, especially at 7 months old (remember, I'm just addressing the plagio). There's not much of a downside to the band, in my mind, other than the cost, in cases like yours and mine where insurance doesn't cover it. We have United Healthcare and also have a written exclusion in our policy for cranial banding and were therefore denied. I'm not sure whether we'll appeal or not--haven't heard of any successful appeals in the case of an exclusion, but maybe it's worth trying. In the meantime we've paid out of pocket for our DOCband so we could get going. We also tried the route of checking with our employer's HR rep who handles the insurance. She had the company's insurance "advocate" (I had no idea companies hired such people) check with United and all they really did was confirm the exclusion and say we could appeal if we wanted.> > >> > > Hi,> > > I am new to the group. My 7month old son is scheduled on Monday at Cranialtech to be sized for a DOCband. I am still debating if this is the right decision. Just wondering if anyone has opted NOT to do the band and if you have seen postive results?? He has moderate plagiocephaly and brachycephaly but his facial symmetry is very close to normal. > > > > > > Also, and advice on getting treatment covered by insurance? I have Cigna and cranial orthotics are a specific exclusion in my policy. > > > > > > Thanks in advance for your help. So excited to have found this support group!> > > > > > > > >> >>