Re: New-Deco, Tort, Insurance Q's

[Guest guest]

I agree, we changed every 1-2 wks and just peeled it, we got chips

around the edges usually within a few days but it didn't look bad

until about time for a change

As for bcbs, um yeah, not a fan, but I would say that yes they are

full of **** that that is the usual charge for a band as typically

they are well over $2k, however it is quite reasonable to think that

that is their usual and customary contracted amount to a band company,

which means what the cost would be with an in network provider who has

a contrcat to treat for less/a discount. Even if the usual and

customary were decided to be higher, my guess is a fight wouldn't get

it much higher and after a 700 deductible they probably only pay like

60% out of network so you probably wouldn't get a lot but it can never

hurt to try at least, what's the worst they can do, tell you no?

On 4/27/10, nwilkens2275 <nwilkens2275@...> wrote:

> Welcome!-

> I don't think it would hurt to get an official evaluation from an outside PT

> just to be sure you're treating the tort as effectively as possible.

> Although maybe someone else can chime in on that one, because my son's tort

> was resolved by the time he was treated at CT, so we weren't doing stretches

> at that time.

>

> The stretches should resolve the tort eventually, it just depends on how

> severe it is and how dilligent you are in doing them. Again, someone else

> might have a better idea of how long it might take - my son's tort was

> treated very early at 2 months old, and was resolved by the time he was 6

> months old. I do think the older they are, the longer it might take, but it

> should definitely get better.

>

> My son wore 2 DOCBands and had about 10 or 12 different paint jobs total.

> You just peel the paint off, give it a good cleaning with rubbing alcohol

> and start over. You'll have to use 4-6 layers of paint and mod podge

> combined (especially with dark colors), so it will peel off pretty easily (I

> had fun trying to peel the whole thing off in one big piece). I had to

> change paint/designs every 3 weeks. You can do touch ups but it eventually

> starts to look faded and chipped and I would be ready for a change by then.

>

> Unfortunately, I can't answer your last question. I have BCBS but it's the

> federal employee program so is a little different, plus I live in NC and CT

> was covered 75% for me. Hopefully someone else can answer that part for you.

>

> Good luck!

>

> Jake-3.5 (DOCBand Grad 9/08)

> Raleigh, NC

>

>

>

>>

>> Hi all! I'm new to the board. I just brought my son to Dr. Persing at Yale

>> in New Haven, CT. He was great, much better than the first neurosurgeon we

>> saw in CT, who's name I won't mention. I'll just say that if you are

>> looking for a craniofacial doctor in CT, I recommend Yale.

>>

>> Anyway, my son Caleb will be 9 months in a couple days. I brought him to

>> Cranial Tech last week, and he has 11 mm cranial vault assymetry, facial

>> and ear assymetry, and torticollis. We are doing neck stretches and are

>> going to do the DOC band.

>>

>> So, here are my questions:

>> 1. Does anybody have suggestions about whether to continue doing the neck

>> exercises the Cranial Tech PT showed us on our own or find a regular PT in

>> addition to this? I'm thinking right now that, since the folks at Cranial

>> Tech are PT's and we will visit every 2 weeks, we don't need a separate

>> PT.

>> 2. Has anyone not had complete success with the PT stretches? My son is

>> very set in his ways. Though we have been doing the stretches for a few

>> weeks (started on my own before we went to Cranial Tech) and he seems to

>> be getting used to the routine, he is an avid left thumb sucker, and I'm

>> afraid we will have trouble correcting his torticollis. He is old enough

>> to " fight back " and put himself in whatever position he wants to be in

>> while he sleeps, in his car seat, etc. At what point should we seek

>> another consultation? What kind of doctor should we go to for this if

>> needed?

>> 3. Has anyone had success with painting over previous layers of paint on a

>> DOC band? I have two decoration ideas: Red Sox with dark blue paint, and a

>> race car theme with black paint. I want to switch the decorations half way

>> through the three months. Do I just remove the stickers and paint over the

>> previous paint job? Prime over it? Try to peel the last paint job off

>> first?

>> 4. How long will the acrylic paint last before it starts chipping off and

>> looking bad? My son is learning to walk now, so I'm expecting the helmet

>> to get banged up a lot.

>> 5. My insurance is through Empire BC/BS. So far, it appears that they will

>> cover treatment through Cranial Tech, but they set the " reasonable and

>> customary " price at $650-750 " for my area " (Connecticut) as the insurance

>> rep. said. $700 is the amount of my deductible, so insurance wouldn't pay

>> a thing! As far as I'm concerned, that is the same as denying coverage

>> since I can't get treatment for that amount. Cranial Tech is the only

>> provider in CT, and they charge $3,800. Has anyone had luck fighting

>> insurance on the " reasonable and customary " amount?

>>

>> Sorry to make this so long! Thanks so much!

>>

>>

>

>

>

--

Sent from my mobile device

-mommy to Emma, Becca, ,

and

Girl Scout cookies are coming!

[Guest guest]

Yeah, that is the whole problem. They don't contract with Cranial Tech. Empire

did agree to pay it as in network anyway since there isn't another provider

close to me, but at this ridiculously low price. If I can get them to raise the

reasonable and customary amount, they will pay the rest at 90%, so I have a lot

at stake! I set up my appt. for my scan tomorrow. I'm going to go ahead with the

DOC band out of pocket for now, but I have no intention on quitting this fight

with the insurance company, even if I have to file a complaint with the state

insurance department. Watch out Empire, Mama Bear is after you!

> >>

> >> Hi all! I'm new to the board. I just brought my son to Dr. Persing at Yale

> >> in New Haven, CT. He was great, much better than the first neurosurgeon we

> >> saw in CT, who's name I won't mention. I'll just say that if you are

> >> looking for a craniofacial doctor in CT, I recommend Yale.

> >>

> >> Anyway, my son Caleb will be 9 months in a couple days. I brought him to

> >> Cranial Tech last week, and he has 11 mm cranial vault assymetry, facial

> >> and ear assymetry, and torticollis. We are doing neck stretches and are

> >> going to do the DOC band.

> >>

> >> So, here are my questions:

> >> 1. Does anybody have suggestions about whether to continue doing the neck

> >> exercises the Cranial Tech PT showed us on our own or find a regular PT in

> >> addition to this? I'm thinking right now that, since the folks at Cranial

> >> Tech are PT's and we will visit every 2 weeks, we don't need a separate

> >> PT.

> >> 2. Has anyone not had complete success with the PT stretches? My son is

> >> very set in his ways. Though we have been doing the stretches for a few

> >> weeks (started on my own before we went to Cranial Tech) and he seems to

> >> be getting used to the routine, he is an avid left thumb sucker, and I'm

> >> afraid we will have trouble correcting his torticollis. He is old enough

> >> to " fight back " and put himself in whatever position he wants to be in

> >> while he sleeps, in his car seat, etc. At what point should we seek

> >> another consultation? What kind of doctor should we go to for this if

> >> needed?

> >> 3. Has anyone had success with painting over previous layers of paint on a

> >> DOC band? I have two decoration ideas: Red Sox with dark blue paint, and a

> >> race car theme with black paint. I want to switch the decorations half way

> >> through the three months. Do I just remove the stickers and paint over the

> >> previous paint job? Prime over it? Try to peel the last paint job off

> >> first?

> >> 4. How long will the acrylic paint last before it starts chipping off and

> >> looking bad? My son is learning to walk now, so I'm expecting the helmet

> >> to get banged up a lot.

> >> 5. My insurance is through Empire BC/BS. So far, it appears that they will

> >> cover treatment through Cranial Tech, but they set the " reasonable and

> >> customary " price at $650-750 " for my area " (Connecticut) as the insurance

> >> rep. said. $700 is the amount of my deductible, so insurance wouldn't pay

> >> a thing! As far as I'm concerned, that is the same as denying coverage

> >> since I can't get treatment for that amount. Cranial Tech is the only

> >> provider in CT, and they charge $3,800. Has anyone had luck fighting

> >> insurance on the " reasonable and customary " amount?

> >>

> >> Sorry to make this so long! Thanks so much!

> >>

> >>

> >

> >

> >

>

> --

> Sent from my mobile device

>

> -mommy to Emma, Becca, ,

> and

>

> Girl Scout cookies are coming!

>

[Guest guest]

I would go ahead and try and appeal. I've heard that BCBS typically denies everything at first, but my coworker just won her appeal with Carefirst BCBS. Of course, every plan is different, but you might just win.

At the time, we decided not to appeal our plan's denial due to out of network, but I wish that I had and made the argument that my daughter didn't have time for Hanger to go through their process.

Re: New-Deco, Tort, Insurance Q's

Yeah, that is the whole problem. They don't contract with Cranial Tech. Empire did agree to pay it as in network anyway since there isn't another provider close to me, but at this ridiculously low price. If I can get them to raise the reasonable and customary amount, they will pay the rest at 90%, so I have a lot at stake! I set up my appt. for my scan tomorrow. I'm going to go ahead with the DOC band out of pocket for now, but I have no intention on quitting this fight with the insurance company, even if I have to file a complaint with the state insurance department. Watch out Empire, Mama Bear is after you!> >>> >> Hi all! I'm new to the board. I just brought my son to Dr. Persing at Yale> >> in New Haven, CT. He was great, much better than the first neurosurgeon we> >> saw in CT, who's name I won't mention. I'll just say that if you are> >> looking for a craniofacial doctor in CT, I recommend Yale.> >>> >> Anyway, my son Caleb will be 9 months in a couple days. I brought him to> >> Cranial Tech last week, and he has 11 mm cranial vault assymetry, facial> >> and ear assymetry, and torticollis. We are doing neck stretches and are> >> going to do the DOC band.> >>> >> So, here are my questions:> >> 1. Does anybody have suggestions about whether to continue doing the neck> >> exercises the Cranial Tech PT showed us on our own or find a regular PT in> >> addition to this? I'm thinking right now that, since the folks at Cranial> >> Tech are PT's and we will visit every 2 weeks, we don't need a separate> >> PT.> >> 2. Has anyone not had complete success with the PT stretches? My son is> >> very set in his ways. Though we have been doing the stretches for a few> >> weeks (started on my own before we went to Cranial Tech) and he seems to> >> be getting used to the routine, he is an avid left thumb sucker, and I'm> >> afraid we will have trouble correcting his torticollis. He is old enough> >> to "fight back" and put himself in whatever position he wants to be in> >> while he sleeps, in his car seat, etc. At what point should we seek> >> another consultation? What kind of doctor should we go to for this if> >> needed?> >> 3. Has anyone had success with painting over previous layers of paint on a> >> DOC band? I have two decoration ideas: Red Sox with dark blue paint, and a> >> race car theme with black paint. I want to switch the decorations half way> >> through the three months. Do I just remove the stickers and paint over the> >> previous paint job? Prime over it? Try to peel the last paint job off> >> first?> >> 4. How long will the acrylic paint last before it starts chipping off and> >> looking bad? My son is learning to walk now, so I'm expecting the helmet> >> to get banged up a lot.> >> 5. My insurance is through Empire BC/BS. So far, it appears that they will> >> cover treatment through Cranial Tech, but they set the "reasonable and> >> customary" price at $650-750 "for my area" (Connecticut) as the insurance> >> rep. said. $700 is the amount of my deductible, so insurance wouldn't pay> >> a thing! As far as I'm concerned, that is the same as denying coverage> >> since I can't get treatment for that amount. Cranial Tech is the only> >> provider in CT, and they charge $3,800. Has anyone had luck fighting> >> insurance on the "reasonable and customary" amount?> >>> >> Sorry to make this so long! Thanks so much!> >> > >>> >> >> >> > -- > Sent from my mobile device> > -mommy to Emma, Becca, ,> and > > Girl Scout cookies are coming!>

[Guest guest]

My son was diagnosed with torticollis at 2 months old. We started pediatric physical therapy that day. He turned 7 months yesterday and we are still doing PT and he is one month into a DOC Band for plagiocephaly. I would defintely recommend doing PT outside of the DOC band office. Although CT talks to me about stretching, I feel that PT has a better handle on things and gives him good stretching once a week. We have made a lot of progress over 5 months and I am sure we will be in therapy till he is one year.From: stephaniebilliel <SBilliel@...>Subject: New-Deco, Tort, Insurance Q'sPlagiocephaly Date: Tuesday,

April 27, 2010, 8:36 AM

Hi all! I'm new to the board. I just brought my son to Dr. Persing at Yale in New Haven, CT. He was great, much better than the first neurosurgeon we saw in CT, who's name I won't mention. I'll just say that if you are looking for a craniofacial doctor in CT, I recommend Yale.

Anyway, my son Caleb will be 9 months in a couple days. I brought him to Cranial Tech last week, and he has 11 mm cranial vault assymetry, facial and ear assymetry, and torticollis. We are doing neck stretches and are going to do the DOC band.

So, here are my questions:

1. Does anybody have suggestions about whether to continue doing the neck exercises the Cranial Tech PT showed us on our own or find a regular PT in addition to this? I'm thinking right now that, since the folks at Cranial Tech are PT's and we will visit every 2 weeks, we don't need a separate PT.

2. Has anyone not had complete success with the PT stretches? My son is very set in his ways. Though we have been doing the stretches for a few weeks (started on my own before we went to Cranial Tech) and he seems to be getting used to the routine, he is an avid left thumb sucker, and I'm afraid we will have trouble correcting his torticollis. He is old enough to "fight back" and put himself in whatever position he wants to be in while he sleeps, in his car seat, etc. At what point should we seek another consultation? What kind of doctor should we go to for this if needed?

3. Has anyone had success with painting over previous layers of paint on a DOC band? I have two decoration ideas: Red Sox with dark blue paint, and a race car theme with black paint. I want to switch the decorations half way through the three months. Do I just remove the stickers and paint over the previous paint job? Prime over it? Try to peel the last paint job off first?

4. How long will the acrylic paint last before it starts chipping off and looking bad? My son is learning to walk now, so I'm expecting the helmet to get banged up a lot.

5. My insurance is through Empire BC/BS. So far, it appears that they will cover treatment through Cranial Tech, but they set the "reasonable and customary" price at $650-750 "for my area" (Connecticut) as the insurance rep. said. $700 is the amount of my deductible, so insurance wouldn't pay a thing! As far as I'm concerned, that is the same as denying coverage since I can't get treatment for that amount. Cranial Tech is the only provider in CT, and they charge $3,800. Has anyone had luck fighting insurance on the "reasonable and customary" amount?

Sorry to make this so long! Thanks so much!

[Guest guest]

,Welcome to the board. I would say that if your son's tort is not too severe and he's seeing pt's every other week at CT, you should be fine as long as you are seeing improvement in his condition. If you have any reservations about the CT pt, go for the separate PT. My daughter's tort was severe, so we were sent to PT first, before helmet therapy. We did not go through CT because of our insurance(and further research changed my mind about treatment providers.) We had fantastic results with our PT, who has been able to help with other issues related to the tort, such as not rolling over on one side and trying to encourage my daughter to crawl. Also, if the tort is severe enough, it's likely your son would need PT at least once per week until significant improvement occurs.

Hope this helps.Good luck!-Amy From: stephaniebilliel <SBilliel@...>Plagiocephaly Sent: Tue, April 27, 2010 9:36:45 AMSubject: New-Deco, Tort, Insurance Q's

Hi all! I'm new to the board. I just brought my son to Dr. Persing at Yale in New Haven, CT. He was great, much better than the first neurosurgeon we saw in CT, who's name I won't mention. I'll just say that if you are looking for a craniofacial doctor in CT, I recommend Yale.

Anyway, my son Caleb will be 9 months in a couple days. I brought him to Cranial Tech last week, and he has 11 mm cranial vault assymetry, facial and ear assymetry, and torticollis. We are doing neck stretches and are going to do the DOC band.

So, here are my questions:

1. Does anybody have suggestions about whether to continue doing the neck exercises the Cranial Tech PT showed us on our own or find a regular PT in addition to this? I'm thinking right now that, since the folks at Cranial Tech are PT's and we will visit every 2 weeks, we don't need a separate PT.

2. Has anyone not had complete success with the PT stretches? My son is very set in his ways. Though we have been doing the stretches for a few weeks (started on my own before we went to Cranial Tech) and he seems to be getting used to the routine, he is an avid left thumb sucker, and I'm afraid we will have trouble correcting his torticollis. He is old enough to "fight back" and put himself in whatever position he wants to be in while he sleeps, in his car seat, etc. At what point should we seek another consultation? What kind of doctor should we go to for this if needed?

3. Has anyone had success with painting over previous layers of paint on a DOC band? I have two decoration ideas: Red Sox with dark blue paint, and a race car theme with black paint. I want to switch the decorations half way through the three months. Do I just remove the stickers and paint over the previous paint job? Prime over it? Try to peel the last paint job off first?

4. How long will the acrylic paint last before it starts chipping off and looking bad? My son is learning to walk now, so I'm expecting the helmet to get banged up a lot.

5. My insurance is through Empire BC/BS. So far, it appears that they will cover treatment through Cranial Tech, but they set the "reasonable and customary" price at $650-750 "for my area" (Connecticut) as the insurance rep. said. $700 is the amount of my deductible, so insurance wouldn't pay a thing! As far as I'm concerned, that is the same as denying coverage since I can't get treatment for that amount. Cranial Tech is the only provider in CT, and they charge $3,800. Has anyone had luck fighting insurance on the "reasonable and customary" amount?

Sorry to make this so long! Thanks so much!

[Guest guest]

,Just noticed in your post that you have Fed BCBS. Did you have a difficult time getting the insurance company to pay for the band? I have a pending claim with them. It's so frustrating because, as I'm sure you know, they won't authorize coverage until AFTER treatment. Any insight on your experience would be great!Thanks,AmyFrom: Durocher <funwith4@...>To:

Plagiocephaly Sent: Tue, April 27, 2010 6:48:38 PMSubject: Re: New-Deco, Tort, Insurance Q's

I agree, we changed every 1-2 wks and just peeled it, we got chips

around the edges usually within a few days but it didn't look bad

until about time for a change

As for bcbs, um yeah, not a fan, but I would say that yes they are

full of **** that that is the usual charge for a band as typically

they are well over $2k, however it is quite reasonable to think that

that is their usual and customary contracted amount to a band company,

which means what the cost would be with an in network provider who has

a contrcat to treat for less/a discount. Even if the usual and

customary were decided to be higher, my guess is a fight wouldn't get

it much higher and after a 700 deductible they probably only pay like

60% out of network so you probably wouldn't get a lot but it can never

hurt to try at least, what's the worst they can do, tell you no?

On 4/27/10, nwilkens2275 <nwilkens2275> wrote:

> Welcome!-

> I don't think it would hurt to get an official evaluation from an outside PT

> just to be sure you're treating the tort as effectively as possible.

> Although maybe someone else can chime in on that one, because my son's tort

> was resolved by the time he was treated at CT, so we weren't doing stretches

> at that time.

>

> The stretches should resolve the tort eventually, it just depends on how

> severe it is and how dilligent you are in doing them. Again, someone else

> might have a better idea of how long it might take - my son's tort was

> treated very early at 2 months old, and was resolved by the time he was 6

> months old. I do think the older they are, the longer it might take, but it

> should definitely get better.

>

> My son wore 2 DOCBands and had about 10 or 12 different paint jobs total.

> You just peel the paint off, give it a good cleaning with rubbing alcohol

> and start over. You'll have to use 4-6 layers of paint and mod podge

> combined (especially with dark colors), so it will peel off pretty easily (I

> had fun trying to peel the whole thing off in one big piece). I had to

> change paint/designs every 3 weeks. You can do touch ups but it eventually

> starts to look faded and chipped and I would be ready for a change by then.

>

> Unfortunately, I can't answer your last question. I have BCBS but it's the

> federal employee program so is a little different, plus I live in NC and CT

> was covered 75% for me. Hopefully someone else can answer that part for you.

>

> Good luck!

>

> Jake-3.5 (DOCBand Grad 9/08)

> Raleigh, NC

>

>

>

>>

>> Hi all! I'm new to the board. I just brought my son to Dr. Persing at Yale

>> in New Haven, CT. He was great, much better than the first neurosurgeon we

>> saw in CT, who's name I won't mention. I'll just say that if you are

>> looking for a craniofacial doctor in CT, I recommend Yale.

>>

>> Anyway, my son Caleb will be 9 months in a couple days. I brought him to

>> Cranial Tech last week, and he has 11 mm cranial vault assymetry, facial

>> and ear assymetry, and torticollis. We are doing neck stretches and are

>> going to do the DOC band.

>>

>> So, here are my questions:

>> 1. Does anybody have suggestions about whether to continue doing the neck

>> exercises the Cranial Tech PT showed us on our own or find a regular PT in

>> addition to this? I'm thinking right now that, since the folks at Cranial

>> Tech are PT's and we will visit every 2 weeks, we don't need a separate

>> PT.

>> 2. Has anyone not had complete success with the PT stretches? My son is

>> very set in his ways. Though we have been doing the stretches for a few

>> weeks (started on my own before we went to Cranial Tech) and he seems to

>> be getting used to the routine, he is an avid left thumb sucker, and I'm

>> afraid we will have trouble correcting his torticollis. He is old enough

>> to "fight back" and put himself in whatever position he wants to be in

>> while he sleeps, in his car seat, etc. At what point should we seek

>> another consultation? What kind of doctor should we go to for this if

>> needed?

>> 3. Has anyone had success with painting over previous layers of paint on a

>> DOC band? I have two decoration ideas: Red Sox with dark blue paint, and a

>> race car theme with black paint. I want to switch the decorations half way

>> through the three months. Do I just remove the stickers and paint over the

>> previous paint job? Prime over it? Try to peel the last paint job off

>> first?

>> 4. How long will the acrylic paint last before it starts chipping off and

>> looking bad? My son is learning to walk now, so I'm expecting the helmet

>> to get banged up a lot.

>> 5. My insurance is through Empire BC/BS. So far, it appears that they will

>> cover treatment through Cranial Tech, but they set the "reasonable and

>> customary" price at $650-750 "for my area" (Connecticut) as the insurance

>> rep. said. $700 is the amount of my deductible, so insurance wouldn't pay

>> a thing! As far as I'm concerned, that is the same as denying coverage

>> since I can't get treatment for that amount. Cranial Tech is the only

>> provider in CT, and they charge $3,800. Has anyone had luck fighting

>> insurance on the "reasonable and customary" amount?

>>

>> Sorry to make this so long! Thanks so much!

>>

>>

>

>

>

--

Sent from my mobile device

-mommy to Emma, Becca, ,

and

Girl Scout cookies are coming!

[Guest guest]

Hi Amy-

I think you might be referring to me? I have BCBS FEP for North Carolina (and I

couldn't see in 's post where she mentions the fed program). I actually

didn't have any trouble with them at all and did not have to wait until after

treatment to get reimbursed. I submitted my claim right away (after paying up

front for the band) and received a reimbursement check within 2 weeks, no

questions asked. I know BCBS FEP (as well as regular BCBS) varies greatly from

state to state and plan to plan (I have the Standard/highest level plan within

the FEP). I seem to be one of the very lucky ones that didn't have much trouble

with insurance coverage.

Good luck with your claim!

Jake-3.5 (DOCBand Grad 9/08)

Raleigh, NC

> >>

> >> Hi all! I'm new to the board. I just brought my son to Dr. Persing at Yale

> >> in New Haven, CT. He was great, much better than the first neurosurgeon we

> >> saw in CT, who's name I won't mention. I'll just say that if you are

> >> looking for a craniofacial doctor in CT, I recommend Yale.

> >>

> >> Anyway, my son Caleb will be 9 months in a couple days. I brought him to

> >> Cranial Tech last week, and he has 11 mm cranial vault assymetry, facial

> >> and ear assymetry, and torticollis. We are doing neck stretches and are

> >> going to do the DOC band.

> >>

> >> So, here are my questions:

> >> 1. Does anybody have suggestions about whether to continue doing the neck

> >> exercises the Cranial Tech PT showed us on our own or find a regular PT in

> >> addition to this? I'm thinking right now that, since the folks at Cranial

> >> Tech are PT's and we will visit every 2 weeks, we don't need a separate

> >> PT.

> >> 2. Has anyone not had complete success with the PT stretches? My son is

> >> very set in his ways. Though we have been doing the stretches for a few

> >> weeks (started on my own before we went to Cranial Tech) and he seems to

> >> be getting used to the routine, he is an avid left thumb sucker, and I'm

> >> afraid we will have trouble correcting his torticollis. He is old enough

> >> to " fight back " and put himself in whatever position he wants to be in

> >> while he sleeps, in his car seat, etc. At what point should we seek

> >> another consultation? What kind of doctor should we go to for this if

> >> needed?

> >> 3. Has anyone had success with painting over previous layers of paint on a

> >> DOC band? I have two decoration ideas: Red Sox with dark blue paint, and a

> >> race car theme with black paint. I want to switch the decorations half way

> >> through the three months. Do I just remove the stickers and paint over the

> >> previous paint job? Prime over it? Try to peel the last paint job off

> >> first?

> >> 4. How long will the acrylic paint last before it starts chipping off and

> >> looking bad? My son is learning to walk now, so I'm expecting the helmet

> >> to get banged up a lot.

> >> 5. My insurance is through Empire BC/BS. So far, it appears that they will

> >> cover treatment through Cranial Tech, but they set the " reasonable and

> >> customary " price at $650-750 " for my area " (Connecticut) as the insurance

> >> rep. said. $700 is the amount of my deductible, so insurance wouldn't pay

> >> a thing! As far as I'm concerned, that is the same as denying coverage

> >> since I can't get treatment for that amount. Cranial Tech is the only

> >> provider in CT, and they charge $3,800. Has anyone had luck fighting

> >> insurance on the " reasonable and customary " amount?

> >>

> >> Sorry to make this so long! Thanks so much!

> >>

> >>

> >

> >

> >

>

> --

> Sent from my mobile device

>

> -mommy to Emma, Becca, ,

> and

>

> Girl Scout cookies are coming!

>

[Guest guest]

Hi ,Sorry about he mix up in names. I also have standard option BCBS FEP, but it's out of land. Wow! I can't believe you were reimbursed in only two weeks. Perhaps, I should have just submitted the claim myself and things may have gone faster. The band provider filed the claim for me and I paid upfront for it almost two months ago. I guess I was a little vague in my post. What I meant to say is that BCBS wouldn't say whether they'd cover the band until after we paid for it and submitted our claim. They have medical reviewers who determine whether helmet therapy is "medically necessary." You're right plans can vary state by state. We'll see what happens.. I appreciate your insight.Thanks,Amy From: nwilkens2275 <nwilkens2275@...>Plagiocephaly Sent: Wed, April 28, 2010 12:45:41 PMSubject: Re: New-Deco, Tort, Insurance Q's

Hi Amy-

I think you might be referring to me? I have BCBS FEP for North Carolina (and I couldn't see in 's post where she mentions the fed program). I actually didn't have any trouble with them at all and did not have to wait until after treatment to get reimbursed. I submitted my claim right away (after paying up front for the band) and received a reimbursement check within 2 weeks, no questions asked. I know BCBS FEP (as well as regular BCBS) varies greatly from state to state and plan to plan (I have the Standard/highest level plan within the FEP). I seem to be one of the very lucky ones that didn't have much trouble with insurance coverage.

Good luck with your claim!

Jake-3.5 (DOCBand Grad 9/08)

Raleigh, NC

> >>

> >> Hi all! I'm new to the board. I just brought my son to Dr. Persing at Yale

> >> in New Haven, CT. He was great, much better than the first neurosurgeon we

> >> saw in CT, who's name I won't mention. I'll just say that if you are

> >> looking for a craniofacial doctor in CT, I recommend Yale.

> >>

> >> Anyway, my son Caleb will be 9 months in a couple days. I brought him to

> >> Cranial Tech last week, and he has 11 mm cranial vault assymetry, facial

> >> and ear assymetry, and torticollis. We are doing neck stretches and are

> >> going to do the DOC band.

> >>

> >> So, here are my questions:

> >> 1. Does anybody have suggestions about whether to continue doing the neck

> >> exercises the Cranial Tech PT showed us on our own or find a regular PT in

> >> addition to this? I'm thinking right now that, since the folks at Cranial

> >> Tech are PT's and we will visit every 2 weeks, we don't need a separate

> >> PT.

> >> 2. Has anyone not had complete success with the PT stretches? My son is

> >> very set in his ways. Though we have been doing the stretches for a few

> >> weeks (started on my own before we went to Cranial Tech) and he seems to

> >> be getting used to the routine, he is an avid left thumb sucker, and I'm

> >> afraid we will have trouble correcting his torticollis. He is old enough

> >> to "fight back" and put himself in whatever position he wants to be in

> >> while he sleeps, in his car seat, etc. At what point should we seek

> >> another consultation? What kind of doctor should we go to for this if

> >> needed?

> >> 3. Has anyone had success with painting over previous layers of paint on a

> >> DOC band? I have two decoration ideas: Red Sox with dark blue paint, and a

> >> race car theme with black paint. I want to switch the decorations half way

> >> through the three months. Do I just remove the stickers and paint over the

> >> previous paint job? Prime over it? Try to peel the last paint job off

> >> first?

> >> 4. How long will the acrylic paint last before it starts chipping off and

> >> looking bad? My son is learning to walk now, so I'm expecting the helmet

> >> to get banged up a lot.

> >> 5. My insurance is through Empire BC/BS. So far, it appears that they will

> >> cover treatment through Cranial Tech, but they set the "reasonable and

> >> customary" price at $650-750 "for my area" (Connecticut) as the insurance

> >> rep. said. $700 is the amount of my deductible, so insurance wouldn't pay

> >> a thing! As far as I'm concerned, that is the same as denying coverage

> >> since I can't get treatment for that amount. Cranial Tech is the only

> >> provider in CT, and they charge $3,800. Has anyone had luck fighting

> >> insurance on the "reasonable and customary" amount?

> >>

> >> Sorry to make this so long! Thanks so much!

> >>

> >>

> >

> >

> >

>

> --

> Sent from my mobile device

>

> -mommy to Emma, Becca, ,

> and

>

> Girl Scout cookies are coming!

>

[Guest guest]

Hi Amy-

Since CT was out of network for us, I had to pay up front and then submit the

claim myself, so that might be the difference. Plus, I had a letter of medical

necessity from our craniofacial surgeon, so maybe it didn't need to be reviewed

beyond that (our NC plan specified that a letter was required or it wouldn't be

covered, so I submitted the it with the claim). Even though I had all my ducks

in a row, I was still stressed that they wouldn't cover it, so was pleasantly

surprised when the check arrived. I hope you get yours soon!

Jake-3.5 (DOCBand Grad 9/08)

Raleigh, NC

> > >>

> > >> Hi all! I'm new to the board. I just brought my son to Dr. Persing at

Yale

> > >> in New Haven, CT. He was great, much better than the first neurosurgeon

we

> > >> saw in CT, who's name I won't mention. I'll just say that if you are

> > >> looking for a craniofacial doctor in CT, I recommend Yale.

> > >>

> > >> Anyway, my son Caleb will be 9 months in a couple days. I brought him to

> > >> Cranial Tech last week, and he has 11 mm cranial vault assymetry, facial

> > >> and ear assymetry, and torticollis. We are doing neck stretches and are

> > >> going to do the DOC band.

> > >>

> > >> So, here are my questions:

> > >> 1. Does anybody have suggestions about whether to continue doing the neck

> > >> exercises the Cranial Tech PT showed us on our own or find a regular PT

in

> > >> addition to this? I'm thinking right now that, since the folks at Cranial

> > >> Tech are PT's and we will visit every 2 weeks, we don't need a separate

> > >> PT.

> > >> 2. Has anyone not had complete success with the PT stretches? My son is

> > >> very set in his ways. Though we have been doing the stretches for a few

> > >> weeks (started on my own before we went to Cranial Tech) and he seems to

> > >> be getting used to the routine, he is an avid left thumb sucker, and I'm

> > >> afraid we will have trouble correcting his torticollis. He is old enough

> > >> to " fight back " and put himself in whatever position he wants to be in

> > >> while he sleeps, in his car seat, etc. At what point should we seek

> > >> another consultation? What kind of doctor should we go to for this if

> > >> needed?

> > >> 3. Has anyone had success with painting over previous layers of paint on

a

> > >> DOC band? I have two decoration ideas: Red Sox with dark blue paint, and

a

> > >> race car theme with black paint. I want to switch the decorations half

way

> > >> through the three months. Do I just remove the stickers and paint over

the

> > >> previous paint job? Prime over it? Try to peel the last paint job off

> > >> first?

> > >> 4. How long will the acrylic paint last before it starts chipping off and

> > >> looking bad? My son is learning to walk now, so I'm expecting the helmet

> > >> to get banged up a lot.

> > >> 5. My insurance is through Empire BC/BS. So far, it appears that they

will

> > >> cover treatment through Cranial Tech, but they set the " reasonable and

> > >> customary " price at $650-750 " for my area " (Connecticut) as the insurance

> > >> rep. said. $700 is the amount of my deductible, so insurance wouldn't pay

> > >> a thing! As far as I'm concerned, that is the same as denying coverage

> > >> since I can't get treatment for that amount. Cranial Tech is the only

> > >> provider in CT, and they charge $3,800. Has anyone had luck fighting

> > >> insurance on the " reasonable and customary " amount?

> > >>

> > >> Sorry to make this so long! Thanks so much!

> > >>

> > >>

> > >

> > >

> > >

> >

> > --

> > Sent from my mobile device

> >

> > -mommy to Emma, Becca, ,

> > and

> >

> > Girl Scout cookies are coming!

> >

>

[Guest guest]

,Would you mind sharing minor details about your letter of medical necessity? Did it specifically say that banding was "medically necessary"? Our neurosurgeon wrote a letter on our behalf that included measurements of my daughter's head, his assessment of her severe plagio and his recommendation for helmet therapy to correct her condition as well as history. It did not specifically state"medically necessary." I hope it will be sufficient. You're right about the way the claim was handled. CT was out of network for us also, so we went with an in-network provider, who filed the claim for us.Thanks for the info.-Amy From: nwilkens2275 <nwilkens2275@...>Plagiocephaly Sent: Wed, April 28, 2010 8:26:06 PMSubject: Re: New-Deco, Tort, Insurance Q's

Hi Amy-

Since CT was out of network for us, I had to pay up front and then submit the claim myself, so that might be the difference. Plus, I had a letter of medical necessity from our craniofacial surgeon, so maybe it didn't need to be reviewed beyond that (our NC plan specified that a letter was required or it wouldn't be covered, so I submitted the it with the claim). Even though I had all my ducks in a row, I was still stressed that they wouldn't cover it, so was pleasantly surprised when the check arrived. I hope you get yours soon!

Jake-3.5 (DOCBand Grad 9/08)

Raleigh, NC

> > >>

> > >> Hi all! I'm new to the board. I just brought my son to Dr. Persing at Yale

> > >> in New Haven, CT. He was great, much better than the first neurosurgeon we

> > >> saw in CT, who's name I won't mention. I'll just say that if you are

> > >> looking for a craniofacial doctor in CT, I recommend Yale.

> > >>

> > >> Anyway, my son Caleb will be 9 months in a couple days. I brought him to

> > >> Cranial Tech last week, and he has 11 mm cranial vault assymetry, facial

> > >> and ear assymetry, and torticollis. We are doing neck stretches and are

> > >> going to do the DOC band.

> > >>

> > >> So, here are my questions:

> > >> 1. Does anybody have suggestions about whether to continue doing the neck

> > >> exercises the Cranial Tech PT showed us on our own or find a regular PT in

> > >> addition to this? I'm thinking right now that, since the folks at Cranial

> > >> Tech are PT's and we will visit every 2 weeks, we don't need a separate

> > >> PT.

> > >> 2. Has anyone not had complete success with the PT stretches? My son is

> > >> very set in his ways. Though we have been doing the stretches for a few

> > >> weeks (started on my own before we went to Cranial Tech) and he seems to

> > >> be getting used to the routine, he is an avid left thumb sucker, and I'm

> > >> afraid we will have trouble correcting his torticollis. He is old enough

> > >> to "fight back" and put himself in whatever position he wants to be in

> > >> while he sleeps, in his car seat, etc. At what point should we seek

> > >> another consultation? What kind of doctor should we go to for this if

> > >> needed?

> > >> 3. Has anyone had success with painting over previous layers of paint on a

> > >> DOC band? I have two decoration ideas: Red Sox with dark blue paint, and a

> > >> race car theme with black paint. I want to switch the decorations half way

> > >> through the three months. Do I just remove the stickers and paint over the

> > >> previous paint job? Prime over it? Try to peel the last paint job off

> > >> first?

> > >> 4. How long will the acrylic paint last before it starts chipping off and

> > >> looking bad? My son is learning to walk now, so I'm expecting the helmet

> > >> to get banged up a lot.

> > >> 5. My insurance is through Empire BC/BS. So far, it appears that they will

> > >> cover treatment through Cranial Tech, but they set the "reasonable and

> > >> customary" price at $650-750 "for my area" (Connecticut) as the insurance

> > >> rep. said. $700 is the amount of my deductible, so insurance wouldn't pay

> > >> a thing! As far as I'm concerned, that is the same as denying coverage

> > >> since I can't get treatment for that amount. Cranial Tech is the only

> > >> provider in CT, and they charge $3,800. Has anyone had luck fighting

> > >> insurance on the "reasonable and customary" amount?

> > >>

> > >> Sorry to make this so long! Thanks so much!

> > >>

> > >>

> > >

> > >

> > >

> >

> > --

> > Sent from my mobile device

> >

> > -mommy to Emma, Becca, ,

> > and

> >

> > Girl Scout cookies are coming!

> >

>

[Guest guest]

Sorry, wasn't me, I have sc. Bcbs and actually they are just the

middle man, dhs work is self insured so I went around bcbs and got

great coverage

On 4/28/10, Amy McGinnis <mcg_woo@...> wrote:

> ,

>

> Just noticed in your post that you have Fed BCBS. Did you have a difficult

> time getting the insurance company to pay for the band? I have a pending

> claim with them. It's so frustrating because, as I'm sure you know, they

> won't authorize coverage until AFTER treatment. Any insight on your

> experience would be great!

> Thanks,

> Amy

>

>

>

>

> ________________________________

> From: Durocher <funwith4@...>

> Plagiocephaly

> Sent: Tue, April 27, 2010 6:48:38 PM

> Subject: Re: New-Deco, Tort, Insurance Q's

>

>

> I agree, we changed every 1-2 wks and just peeled it, we got chips

> around the edges usually within a few days but it didn't look bad

> until about time for a change

>

> As for bcbs, um yeah, not a fan, but I would say that yes they are

> full of **** that that is the usual charge for a band as typically

> they are well over $2k, however it is quite reasonable to think that

> that is their usual and customary contracted amount to a band company,

> which means what the cost would be with an in network provider who has

> a contrcat to treat for less/a discount. Even if the usual and

> customary were decided to be higher, my guess is a fight wouldn't get

> it much higher and after a 700 deductible they probably only pay like

> 60% out of network so you probably wouldn't get a lot but it can never

> hurt to try at least, what's the worst they can do, tell you no?

>

> On 4/27/10, nwilkens2275 <nwilkens2275> wrote:

>> Welcome!-

>> I don't think it would hurt to get an official evaluation from an outside

>> PT

>> just to be sure you're treating the tort as effectively as possible.

>> Although maybe someone else can chime in on that one, because my son's

>> tort

>> was resolved by the time he was treated at CT, so we weren't doing

>> stretches

>> at that time.

>>

>> The stretches should resolve the tort eventually, it just depends on how

>> severe it is and how dilligent you are in doing them. Again, someone else

>> might have a better idea of how long it might take - my son's tort was

>> treated very early at 2 months old, and was resolved by the time he was 6

>> months old. I do think the older they are, the longer it might take, but

>> it

>> should definitely get better.

>>

>> My son wore 2 DOCBands and had about 10 or 12 different paint jobs total.

>> You just peel the paint off, give it a good cleaning with rubbing alcohol

>> and start over. You'll have to use 4-6 layers of paint and mod podge

>> combined (especially with dark colors), so it will peel off pretty easily

>> (I

>> had fun trying to peel the whole thing off in one big piece). I had to

>> change paint/designs every 3 weeks. You can do touch ups but it eventually

>> starts to look faded and chipped and I would be ready for a change by

>> then.

>>

>> Unfortunately, I can't answer your last question. I have BCBS but it's the

>> federal employee program so is a little different, plus I live in NC and

>> CT

>> was covered 75% for me. Hopefully someone else can answer that part for

>> you.

>>

>> Good luck!

>>

>> Jake-3.5 (DOCBand Grad 9/08)

>> Raleigh, NC

>>

>>

>>

>>>

>>> Hi all! I'm new to the board. I just brought my son to Dr. Persing at

>>> Yale

>>> in New Haven, CT. He was great, much better than the first neurosurgeon

>>> we

>>> saw in CT, who's name I won't mention. I'll just say that if you are

>>> looking for a craniofacial doctor in CT, I recommend Yale.

>>>

>>> Anyway, my son Caleb will be 9 months in a couple days. I brought him to

>>> Cranial Tech last week, and he has 11 mm cranial vault assymetry, facial

>>> and ear assymetry, and torticollis. We are doing neck stretches and are

>>> going to do the DOC band.

>>>

>>> So, here are my questions:

>>> 1. Does anybody have suggestions about whether to continue doing the neck

>>> exercises the Cranial Tech PT showed us on our own or find a regular PT

>>> in

>>> addition to this? I'm thinking right now that, since the folks at Cranial

>>> Tech are PT's and we will visit every 2 weeks, we don't need a separate

>>> PT.

>>> 2. Has anyone not had complete success with the PT stretches? My son is

>>> very set in his ways. Though we have been doing the stretches for a few

>>> weeks (started on my own before we went to Cranial Tech) and he seems to

>>> be getting used to the routine, he is an avid left thumb sucker, and I'm

>>> afraid we will have trouble correcting his torticollis. He is old enough

>>> to " fight back " and put himself in whatever position he wants to be in

>>> while he sleeps, in his car seat, etc. At what point should we seek

>>> another consultation? What kind of doctor should we go to for this if

>>> needed?

>>> 3. Has anyone had success with painting over previous layers of paint on

>>> a

>>> DOC band? I have two decoration ideas: Red Sox with dark blue paint, and

>>> a

>>> race car theme with black paint. I want to switch the decorations half

>>> way

>>> through the three months. Do I just remove the stickers and paint over

>>> the

>>> previous paint job? Prime over it? Try to peel the last paint job off

>>> first?

>>> 4. How long will the acrylic paint last before it starts chipping off and

>>> looking bad? My son is learning to walk now, so I'm expecting the helmet

>>> to get banged up a lot.

>>> 5. My insurance is through Empire BC/BS. So far, it appears that they

>>> will

>>> cover treatment through Cranial Tech, but they set the " reasonable and

>>> customary " price at $650-750 " for my area " (Connecticut) as the insurance

>>> rep. said. $700 is the amount of my deductible, so insurance wouldn't pay

>>> a thing! As far as I'm concerned, that is the same as denying coverage

>>> since I can't get treatment for that amount. Cranial Tech is the only

>>> provider in CT, and they charge $3,800. Has anyone had luck fighting

>>> insurance on the " reasonable and customary " amount?

>>>

>>> Sorry to make this so long! Thanks so much!

>>>

>>>

>>

>>

>>

>

> --

> Sent from my mobile device

>

> -mommy to Emma, Becca, ,

> and

>

> Girl Scout cookies are coming!

>

>

>

>

>

--

Sent from my mobile device

-mommy to Emma, Becca, ,

and

Girl Scout cookies are coming!

[Guest guest]

,Sorry for the mix up. That's great that you had such a good experience with insurance coverage.-AmyFrom: Durocher <funwith4@...>Plagiocephaly Sent: Wed, April 28, 2010 8:50:26 PMSubject: Re: New-Deco, Tort, Insurance Q's

Sorry, wasn't me, I have sc. Bcbs and actually they are just the

middle man, dhs work is self insured so I went around bcbs and got

great coverage

On 4/28/10, Amy McGinnis <mcg_woo (DOT) com> wrote:

> ,

>

> Just noticed in your post that you have Fed BCBS. Did you have a difficult

> time getting the insurance company to pay for the band? I have a pending

> claim with them. It's so frustrating because, as I'm sure you know, they

> won't authorize coverage until AFTER treatment. Any insight on your

> experience would be great!

> Thanks,

> Amy

>

>

>

>

> ____________ _________ _________ __

> From: Durocher <funwith4gmail (DOT) com>

> Plagiocephaly

> Sent: Tue, April 27, 2010 6:48:38 PM

> Subject: Re: New-Deco, Tort, Insurance Q's

>

>

> I agree, we changed every 1-2 wks and just peeled it, we got chips

> around the edges usually within a few days but it didn't look bad

> until about time for a change

>

> As for bcbs, um yeah, not a fan, but I would say that yes they are

> full of **** that that is the usual charge for a band as typically

> they are well over $2k, however it is quite reasonable to think that

> that is their usual and customary contracted amount to a band company,

> which means what the cost would be with an in network provider who has

> a contrcat to treat for less/a discount. Even if the usual and

> customary were decided to be higher, my guess is a fight wouldn't get

> it much higher and after a 700 deductible they probably only pay like

> 60% out of network so you probably wouldn't get a lot but it can never

> hurt to try at least, what's the worst they can do, tell you no?

>

> On 4/27/10, nwilkens2275 <nwilkens2275> wrote:

>> Welcome!-

>> I don't think it would hurt to get an official evaluation from an outside

>> PT

>> just to be sure you're treating the tort as effectively as possible.

>> Although maybe someone else can chime in on that one, because my son's

>> tort

>> was resolved by the time he was treated at CT, so we weren't doing

>> stretches

>> at that time.

>>

>> The stretches should resolve the tort eventually, it just depends on how

>> severe it is and how dilligent you are in doing them. Again, someone else

>> might have a better idea of how long it might take - my son's tort was

>> treated very early at 2 months old, and was resolved by the time he was 6

>> months old. I do think the older they are, the longer it might take, but

>> it

>> should definitely get better.

>>

>> My son wore 2 DOCBands and had about 10 or 12 different paint jobs total.

>> You just peel the paint off, give it a good cleaning with rubbing alcohol

>> and start over. You'll have to use 4-6 layers of paint and mod podge

>> combined (especially with dark colors), so it will peel off pretty easily

>> (I

>> had fun trying to peel the whole thing off in one big piece). I had to

>> change paint/designs every 3 weeks. You can do touch ups but it eventually

>> starts to look faded and chipped and I would be ready for a change by

>> then.

>>

>> Unfortunately, I can't answer your last question. I have BCBS but it's the

>> federal employee program so is a little different, plus I live in NC and

>> CT

>> was covered 75% for me. Hopefully someone else can answer that part for

>> you.

>>

>> Good luck!

>>

>> Jake-3.5 (DOCBand Grad 9/08)

>> Raleigh, NC

>>

>>

>>

>>>

>>> Hi all! I'm new to the board. I just brought my son to Dr. Persing at

>>> Yale

>>> in New Haven, CT. He was great, much better than the first neurosurgeon

>>> we

>>> saw in CT, who's name I won't mention. I'll just say that if you are

>>> looking for a craniofacial doctor in CT, I recommend Yale.

>>>

>>> Anyway, my son Caleb will be 9 months in a couple days. I brought him to

>>> Cranial Tech last week, and he has 11 mm cranial vault assymetry, facial

>>> and ear assymetry, and torticollis. We are doing neck stretches and are

>>> going to do the DOC band.

>>>

>>> So, here are my questions:

>>> 1. Does anybody have suggestions about whether to continue doing the neck

>>> exercises the Cranial Tech PT showed us on our own or find a regular PT

>>> in

>>> addition to this? I'm thinking right now that, since the folks at Cranial

>>> Tech are PT's and we will visit every 2 weeks, we don't need a separate

>>> PT.

>>> 2. Has anyone not had complete success with the PT stretches? My son is

>>> very set in his ways. Though we have been doing the stretches for a few

>>> weeks (started on my own before we went to Cranial Tech) and he seems to

>>> be getting used to the routine, he is an avid left thumb sucker, and I'm

>>> afraid we will have trouble correcting his torticollis. He is old enough

>>> to "fight back" and put himself in whatever position he wants to be in

>>> while he sleeps, in his car seat, etc. At what point should we seek

>>> another consultation? What kind of doctor should we go to for this if

>>> needed?

>>> 3. Has anyone had success with painting over previous layers of paint on

>>> a

>>> DOC band? I have two decoration ideas: Red Sox with dark blue paint, and

>>> a

>>> race car theme with black paint. I want to switch the decorations half

>>> way

>>> through the three months. Do I just remove the stickers and paint over

>>> the

>>> previous paint job? Prime over it? Try to peel the last paint job off

>>> first?

>>> 4. How long will the acrylic paint last before it starts chipping off and

>>> looking bad? My son is learning to walk now, so I'm expecting the helmet

>>> to get banged up a lot.

>>> 5. My insurance is through Empire BC/BS. So far, it appears that they

>>> will

>>> cover treatment through Cranial Tech, but they set the "reasonable and

>>> customary" price at $650-750 "for my area" (Connecticut) as the insurance

>>> rep. said. $700 is the amount of my deductible, so insurance wouldn't pay

>>> a thing! As far as I'm concerned, that is the same as denying coverage

>>> since I can't get treatment for that amount. Cranial Tech is the only

>>> provider in CT, and they charge $3,800. Has anyone had luck fighting

>>> insurance on the "reasonable and customary" amount?

>>>

>>> Sorry to make this so long! Thanks so much!

>>>

>>>

>>

>>

>>

>

> --

> Sent from my mobile device

>

> -mommy to Emma, Becca, ,

> and

>

> Girl Scout cookies are coming!

>

>

>

>

>

--

Sent from my mobile device

-mommy to Emma, Becca, ,

and

Girl Scout cookies are coming!

[Guest guest]

I know that this question wasn't directed to me, but I can tell you that my coworker told me that her doctor's letter include references to legal cases where the family had won. That might be a critical factor for an insurance company. Apparently her doctor had a baby's dad who was a lawyer and had successfully sued and won an insurance company. She doesn't know any other details.

So, have the doctor include some legal references. Re: New-Deco, Tort, Insurance Q's

Hi Amy-Since CT was out of network for us, I had to pay up front and then submit the claim myself, so that might be the difference. Plus, I had a letter of medical necessity from our craniofacial surgeon, so maybe it didn't need to be reviewed beyond that (our NC plan specified that a letter was required or it wouldn't be covered, so I submitted the it with the claim). Even though I had all my ducks in a row, I was still stressed that they wouldn't cover it, so was pleasantly surprised when the check arrived. I hope you get yours soon!Jake-3.5 (DOCBand Grad 9/08)Raleigh, NC > > >>> > >> Hi all! I'm new to the board. I just brought my son to Dr. Persing at Yale> > >> in New Haven, CT. He was great, much better than the first neurosurgeon we> > >> saw in CT, who's name I won't mention. I'll just say that if you are> > >> looking for a craniofacial doctor in CT, I recommend Yale.> > >>> > >> Anyway, my son Caleb will be 9 months in a couple days. I brought him to> > >> Cranial Tech last week, and he has 11 mm cranial vault assymetry, facial> > >> and ear assymetry, and torticollis. We are doing neck stretches and are> > >> going to do the DOC band.> > >>> > >> So, here are my questions:> > >> 1. Does anybody have suggestions about whether to continue doing the neck> > >> exercises the Cranial Tech PT showed us on our own or find a regular PT in> > >> addition to this? I'm thinking right now that, since the folks at Cranial> > >> Tech are PT's and we will visit every 2 weeks, we don't need a separate> > >> PT.> > >> 2. Has anyone not had complete success with the PT stretches? My son is> > >> very set in his ways. Though we have been doing the stretches for a few> > >> weeks (started on my own before we went to Cranial Tech) and he seems to> > >> be getting used to the routine, he is an avid left thumb sucker, and I'm> > >> afraid we will have trouble correcting his torticollis. He is old enough> > >> to "fight back" and put himself in whatever position he wants to be in> > >> while he sleeps, in his car seat, etc. At what point should we seek> > >> another consultation? What kind of doctor should we go to for this if> > >> needed?> > >> 3. Has anyone had success with painting over previous layers of paint on a> > >> DOC band? I have two decoration ideas: Red Sox with dark blue paint, and a> > >> race car theme with black paint. I want to switch the decorations half way> > >> through the three months. Do I just remove the stickers and paint over the> > >> previous paint job? Prime over it? Try to peel the last paint job off> > >> first?> > >> 4. How long will the acrylic paint last before it starts chipping off and> > >> looking bad? My son is learning to walk now, so I'm expecting the helmet> > >> to get banged up a lot.> > >> 5. My insurance is through Empire BC/BS. So far, it appears that they will> > >> cover treatment through Cranial Tech, but they set the "reasonable and> > >> customary" price at $650-750 "for my area" (Connecticut) as the insurance> > >> rep. said. $700 is the amount of my deductible, so insurance wouldn't pay> > >> a thing! As far as I'm concerned, that is the same as denying coverage> > >> since I can't get treatment for that amount. Cranial Tech is the only> > >> provider in CT, and they charge $3,800. Has anyone had luck fighting> > >> insurance on the "reasonable and customary" amount?> > >>> > >> Sorry to make this so long! Thanks so much!> > >> > > >>> > >> > >> > >> > > > -- > > Sent from my mobile device> > > > -mommy to Emma, Becca, ,> > and > > > > Girl Scout cookies are coming!> >>

[Guest guest]

Thanks for the information. Maybe it help others on the board as well.-AmyFrom: <melanie.watson@...>Plagiocephaly Sent: Thu, April 29, 2010 7:33:29 AMSubject: Re: New-Deco, Tort, Insurance Q's

I know that this question wasn't directed to me, but I can tell you that my coworker told me that her doctor's letter include references to legal cases where the family had won. That might be a critical factor for an insurance company. Apparently her doctor had a baby's dad who was a lawyer and had successfully sued and won an insurance company. She doesn't know any other details.

So, have the doctor include some legal references. Re: New-Deco, Tort, Insurance Q's

Hi Amy-Since CT was out of network for us, I had to pay up front and then submit the claim myself, so that might be the difference. Plus, I had a letter of medical necessity from our craniofacial surgeon, so maybe it didn't need to be reviewed beyond that (our NC plan specified that a letter was required or it wouldn't be covered, so I submitted the it with the claim). Even though I had all my ducks in a row, I was still stressed that they wouldn't cover it, so was pleasantly surprised when the check arrived. I hope you get yours soon!Jake-3.5 (DOCBand Grad 9/08)Raleigh, NC > > >>> > >> Hi all! I'm new to the board. I just brought my son to Dr. Persing at Yale> > >> in New Haven, CT. He was great, much better than the first neurosurgeon we> > >> saw in CT, who's name I won't mention. I'll just say that if you are> > >> looking for a craniofacial doctor in CT, I recommend Yale.> > >>> > >> Anyway, my son Caleb will be 9 months in a couple days. I brought him to> > >> Cranial Tech last week, and he has 11 mm cranial vault assymetry, facial>

> >> and ear assymetry, and torticollis. We are doing neck stretches and are> > >> going to do the DOC band.> > >>> > >> So, here are my questions:> > >> 1. Does anybody have suggestions about whether to continue doing the neck> > >> exercises the Cranial Tech PT showed us on our own or find a regular PT in> > >> addition to this? I'm thinking right now that, since the folks at Cranial> > >> Tech are PT's and we will visit every 2 weeks, we don't need a separate> > >> PT.> > >> 2. Has anyone not had complete success with the PT stretches? My son is> > >> very set in his ways. Though we have been doing the stretches for a few> > >> weeks (started on my own before we went to Cranial Tech) and he seems to> > >> be getting used to the routine, he is an avid

left thumb sucker, and I'm> > >> afraid we will have trouble correcting his torticollis. He is old enough> > >> to "fight back" and put himself in whatever position he wants to be in> > >> while he sleeps, in his car seat, etc. At what point should we seek> > >> another consultation? What kind of doctor should we go to for this if> > >> needed?> > >> 3. Has anyone had success with painting over previous layers of paint on a> > >> DOC band? I have two decoration ideas: Red Sox with dark blue paint, and a> > >> race car theme with black paint. I want to switch the decorations half way> > >> through the three months. Do I just remove the stickers and paint over the> > >> previous paint job? Prime over it? Try to peel the last paint job off> > >> first?> > >> 4. How

long will the acrylic paint last before it starts chipping off and> > >> looking bad? My son is learning to walk now, so I'm expecting the helmet> > >> to get banged up a lot.> > >> 5. My insurance is through Empire BC/BS. So far, it appears that they will> > >> cover treatment through Cranial Tech, but they set the "reasonable and> > >> customary" price at $650-750 "for my area" (Connecticut) as the insurance> > >> rep. said. $700 is the amount of my deductible, so insurance wouldn't pay> > >> a thing! As far as I'm concerned, that is the same as denying coverage> > >> since I can't get treatment for that amount. Cranial Tech is the only> > >> provider in CT, and they charge $3,800. Has anyone had luck fighting> > >> insurance on the "reasonable and customary" amount?> >

>>> > >> Sorry to make this so long! Thanks so much!> > >> > > >>> > >> > >> > >> > > > -- > > Sent from my mobile device> > > > -mommy to Emma, Becca, ,> > and > > > > Girl Scout cookies are coming!> >>

[Guest guest]

Amy-

Essentially, it was a form letter that I'm sure the doctor judge inserted my

son's information into (which was fine by me, anything to get the letter in

hand). He held weekly head clinics and was quick to hand out the letters for

insurance purposes. But basically it was 2 pages, referenced my son and his

assessment, and then specifically said it was a medical necessity, and

referenced medical research and information that pointed to that necessity (jaw

issues, etc.). I'd have to dig it out to remember more, but it was pretty

extensive.

Jake-3.5 (DOCBand Grad 9/08)

Raleigh, NC

> > > >>

> > > >> Hi all! I'm new to the board. I just brought my son to Dr. Persing at

Yale

> > > >> in New Haven, CT. He was great, much better than the first neurosurgeon

we

> > > >> saw in CT, who's name I won't mention. I'll just say that if you are

> > > >> looking for a craniofacial doctor in CT, I recommend Yale.

> > > >>

> > > >> Anyway, my son Caleb will be 9 months in a couple days. I brought him

to

> > > >> Cranial Tech last week, and he has 11 mm cranial vault assymetry,

facial

> > > >> and ear assymetry, and torticollis. We are doing neck stretches and are

> > > >> going to do the DOC band.

> > > >>

> > > >> So, here are my questions:

> > > >> 1. Does anybody have suggestions about whether to continue doing the

neck

> > > >> exercises the Cranial Tech PT showed us on our own or find a regular PT

in

> > > >> addition to this? I'm thinking right now that, since the folks at

Cranial

> > > >> Tech are PT's and we will visit every 2 weeks, we don't need a separate

> > > >> PT.

> > > >> 2. Has anyone not had complete success with the PT stretches? My son is

> > > >> very set in his ways. Though we have been doing the stretches for a few

> > > >> weeks (started on my own before we went to Cranial Tech) and he seems

to

> > > >> be getting used to the routine, he is an avid left thumb sucker, and

I'm

> > > >> afraid we will have trouble correcting his torticollis. He is old

enough

> > > >> to " fight back " and put himself in whatever position he wants to be in

> > > >> while he sleeps, in his car seat, etc. At what point should we seek

> > > >> another consultation? What kind of doctor should we go to for this if

> > > >> needed?

> > > >> 3. Has anyone had success with painting over previous layers of paint

on a

> > > >> DOC band? I have two decoration ideas: Red Sox with dark blue paint,

and a

> > > >> race car theme with black paint. I want to switch the decorations half

way

> > > >> through the three months. Do I just remove the stickers and paint over

the

> > > >> previous paint job? Prime over it? Try to peel the last paint job off

> > > >> first?

> > > >> 4. How long will the acrylic paint last before it starts chipping off

and

> > > >> looking bad? My son is learning to walk now, so I'm expecting the

helmet

> > > >> to get banged up a lot.

> > > >> 5. My insurance is through Empire BC/BS. So far, it appears that they

will

> > > >> cover treatment through Cranial Tech, but they set the " reasonable and

> > > >> customary " price at $650-750 " for my area " (Connecticut) as the

insurance

> > > >> rep. said. $700 is the amount of my deductible, so insurance wouldn't

pay

> > > >> a thing! As far as I'm concerned, that is the same as denying coverage

> > > >> since I can't get treatment for that amount. Cranial Tech is the only

> > > >> provider in CT, and they charge $3,800. Has anyone had luck fighting

> > > >> insurance on the " reasonable and customary " amount?

> > > >>

> > > >> Sorry to make this so long! Thanks so much!

> > > >>

> > > >>

> > > >

> > > >

> > > >

> > >

> > > --

> > > Sent from my mobile device

> > >

> > > -mommy to Emma, Becca, ,

> > > and

> > >

> > > Girl Scout cookies are coming!

> > >

> >

>

[Guest guest]

Hello everyone,Just found out that Carefirst BCBS(DC, MD, VA) is reimbursing us for about two--thirds of the cost of our daughter's band through it's preferred provider. So happy I don't have to appeal. Perhaps, the insurance companies are slowly, but surely getting better about covering bands? Now, if we could just get all the pediatricians on board.-AmyFrom: Amy McGinnis <mcg_woo@...>Plagiocephaly Sent: Thu, April 29, 2010 9:02:32 AMSubject: Re: New-Deco, Tort, Insurance Q's

Thanks for the information. Maybe it help others on the board as well.-AmyFrom: <melanie.watson@ comcast.net>PlagiocephalySent: Thu, April 29, 2010 7:33:29 AMSubject: Re: New-Deco, Tort, Insurance Q's

I know that this question wasn't directed to me, but I can tell you that my coworker told me that her doctor's letter include references to legal cases where the family had won. That might be a critical factor for an insurance company. Apparently her doctor had a baby's dad who was a lawyer and had successfully sued and won an insurance company. She doesn't know any other details.

So, have the doctor include some legal references. Re: New-Deco, Tort, Insurance Q's

Hi Amy-Since CT was out of network for us, I had to pay up front and then submit the claim myself, so that might be the difference. Plus, I had a letter of medical necessity from our craniofacial surgeon, so maybe it didn't need to be reviewed beyond that (our NC plan specified that a letter was required or it wouldn't be covered, so I submitted the it with the claim). Even though I had all my ducks in a row, I was still stressed that they wouldn't cover it, so was pleasantly surprised when the check arrived. I hope you get yours soon!Jake-3.5 (DOCBand Grad 9/08)Raleigh, NC > > >>> > >> Hi all! I'm new to the board. I just brought my son to Dr. Persing at Yale> > >> in New Haven, CT. He was great, much better than the first neurosurgeon we> > >> saw in CT, who's name I won't mention. I'll just say that if you are> > >> looking for a craniofacial doctor in CT, I recommend Yale.> > >>> > >> Anyway, my son Caleb will be 9 months in a couple days. I brought him to> > >> Cranial Tech last week, and he has 11 mm cranial vault assymetry, facial>

> >> and ear assymetry, and torticollis. We are doing neck stretches and are> > >> going to do the DOC band.> > >>> > >> So, here are my questions:> > >> 1. Does anybody have suggestions about whether to continue doing the neck> > >> exercises the Cranial Tech PT showed us on our own or find a regular PT in> > >> addition to this? I'm thinking right now that, since the folks at Cranial> > >> Tech are PT's and we will visit every 2 weeks, we don't need a separate> > >> PT.> > >> 2. Has anyone not had complete success with the PT stretches? My son is> > >> very set in his ways. Though we have been doing the stretches for a few> > >> weeks (started on my own before we went to Cranial Tech) and he seems to> > >> be getting used to the routine, he is an avid

left thumb sucker, and I'm> > >> afraid we will have trouble correcting his torticollis. He is old enough> > >> to "fight back" and put himself in whatever position he wants to be in> > >> while he sleeps, in his car seat, etc. At what point should we seek> > >> another consultation? What kind of doctor should we go to for this if> > >> needed?> > >> 3. Has anyone had success with painting over previous layers of paint on a> > >> DOC band? I have two decoration ideas: Red Sox with dark blue paint, and a> > >> race car theme with black paint. I want to switch the decorations half way> > >> through the three months. Do I just remove the stickers and paint over the> > >> previous paint job? Prime over it? Try to peel the last paint job off> > >> first?> > >> 4. How

long will the acrylic paint last before it starts chipping off and> > >> looking bad? My son is learning to walk now, so I'm expecting the helmet> > >> to get banged up a lot.> > >> 5. My insurance is through Empire BC/BS. So far, it appears that they will> > >> cover treatment through Cranial Tech, but they set the "reasonable and> > >> customary" price at $650-750 "for my area" (Connecticut) as the insurance> > >> rep. said. $700 is the amount of my deductible, so insurance wouldn't pay> > >> a thing! As far as I'm concerned, that is the same as denying coverage> > >> since I can't get treatment for that amount. Cranial Tech is the only> > >> provider in CT, and they charge $3,800. Has anyone had luck fighting> > >> insurance on the "reasonable and customary" amount?> >

>>> > >> Sorry to make this so long! Thanks so much!> > >> > > >>> > >> > >> > >> > > > -- > > Sent from my mobile device> > > > -mommy to Emma, Becca, ,> > and > > > > Girl Scout cookies are coming!> >>