Guest guest Posted July 7, 2003 Report Share Posted July 7, 2003 donna - i went to je hanger in nyc for my daughter and was disappointed with results and overall experience. i'm hearing much poitive feedback about ct. just my 2 cents! caroline Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 7, 2003 Report Share Posted July 7, 2003 i'd be curious to hear too. ct told me if i am denied i have to pay the full 3000. can you give details as to why ct said you only had to pay 1600??? caroline Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 7, 2003 Report Share Posted July 7, 2003 I finally got the letter saying that my insurance has denied the DOCband because my Dr's notes dont prove that its medically neccesary. My next step is to get our ped to right a letter to let them know it will benfit Xavier. My ped also told us that our insurance usally doesnt cover DOCbands because they have a contract w/ Hanger but this letter doesnt mention anything about that. Cranial Tech told me that w/ my insurance if I am officially denied that they will only charge us 1600.00 for the DOCband so I am leaning towards this. I am goint to try and see if my insurance will take care of it first but this could take awhile right and I dont want to wait much longer if we are going to get him banded. Donna AZ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 7, 2003 Report Share Posted July 7, 2003 Hi Donna, Sorry to hear about your insurance woes. I'm going through the same thing myself (insurance saying that it's not medically necassary). I've got a question about the $1600. We have officially been denied but CT said that we would have to pay $3000. Do you (or anyone else here) know if that's the case for every CT office or just yours? I thought that they were all pretty much the same (same policies, etc.). Thanks, Jill > I finally got the letter saying that my insurance has denied the > DOCband because my Dr's notes dont prove that its medically > neccesary. My next step is to get our ped to right a letter to let > them know it will benfit Xavier. My ped also told us that our > insurance usally doesnt cover DOCbands because they have a contract > w/ Hanger but this letter doesnt mention anything about that. Cranial > Tech told me that w/ my insurance if I am officially denied that they > will only charge us 1600.00 for the DOCband so I am leaning towards > this. I am goint to try and see if my insurance will take care of it > first but this could take awhile right and I dont want to wait much > longer if we are going to get him banded. > Donna AZ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 7, 2003 Report Share Posted July 7, 2003 Hmm Donna:This is interesting like you said if they normall cover the Hanger Band they find that one med. necessary....gotta love how ins. companies contradict themselves over & over again huh?! But it does sound as if you have a chance. Get your ped. to write up a more detailed letter of med. necessity. Hopefully that'll do the trick!! Keep us posted. Debbie Abby's mom DOCGrad MIDonna <djs611@...> wrote: I finally got the letter saying that my insurance has denied the DOCband because my Dr's notes dont prove that its medically neccesary. My next step is to get our ped to right a letter to let them know it will benfit Xavier. My ped also told us that our insurance usally doesnt cover DOCbands because they have a contract w/ Hanger but this letter doesnt mention anything about that. Cranial Tech told me that w/ my insurance if I am officially denied that they will only charge us 1600.00 for the DOCband so I am leaning towards this. I am goint to try and see if my insurance will take care of it first but this could take awhile right and I dont want to wait much longer if we are going to get him banded.Donna AZFor more plagio info Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 7, 2003 Report Share Posted July 7, 2003 Eek, Donna! Is the Hanger in your area not experienced? Does it say on your denial that CT is not the in-network provider? dustie > I finally got the letter saying that my insurance has denied the > DOCband because my Dr's notes dont prove that its medically > neccesary. My next step is to get our ped to right a letter to let > them know it will benfit Xavier. My ped also told us that our > insurance usally doesnt cover DOCbands because they have a contract > w/ Hanger but this letter doesnt mention anything about that. Cranial > Tech told me that w/ my insurance if I am officially denied that they > will only charge us 1600.00 for the DOCband so I am leaning towards > this. I am goint to try and see if my insurance will take care of it > first but this could take awhile right and I dont want to wait much > longer if we are going to get him banded. > Donna AZ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 6, 2004 Report Share Posted December 6, 2004 In a message dated 12/6/2004 5:46:58 P.M. Eastern Standard Time, colejo74@... writes: direction to point us. We won't be able to get the bands without I just won my second appeal today. We have Anthem Blue Cross. You should appeal it again. Look under the files section at the insurance denials. You can cut and paste info. Also- go to.http://www.cappskids.org/PlagioInsuranceHelp.htm The sample letters here are great and very helpful. We also had the OT at Cranial Technologies write a letter stating the need for our daughter to get the DOC band. Don't give up! It's worth all the trouble. Good luck! Jen Mother of Ally (plagio/tort) Banded 11/2 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 6, 2004 Report Share Posted December 6, 2004 Here is an update from my wife: Well I contacted our State Representative. The lady that I spoke with said to file the appeal process. But looks like if it is denied, then there is nothing I can do. I can't file through the Department of Insurance, because I am a state employee. She is going to double check some information and get back with me. --- In Plagiocephaly , " colejo74 " <colejo74@y...> wrote: > > Hello. This is my first time to post. I have 10 month old twin > daughters that have been to Cranial Tech and they said both are > candidates for the band. My wife sent me an email today with some > bad news though. I just wanted to see if anyone had any ideas or a > direction to point us. We won't be able to get the bands without > help from insurance. > Here's the email from my wife: > > from Cranial tech just called. She said my insurance denied > because it is an experimental procedure. She said that she will send > appeal papers, but with Blue Cross, once they deny something, they > usually don't change their mind. She said they have a payment plan > of 600.00 per month per child. She suggested we get on the > internet. Said there are places that help with contributions. Also > said we may want to contact our State Representative. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 6, 2004 Report Share Posted December 6, 2004 I am sorry for the denial. I have been through it although for different reasons. There are many appeals that have won so don't give up too soon. I am currently on my second appeal. It's frustrating but honestly...don't give up. There are alot of appeals on here under FIles and under Links. Many of us here have just copied and pasted parts of each or just used each others appeals wholely. There is alot of research and information that you can use to prove it's not experimental. Good luck! , mom to 8months (STARband 10/18) > > > > Hello. This is my first time to post. I have 10 month old twin > > daughters that have been to Cranial Tech and they said both are > > candidates for the band. My wife sent me an email today with some > > bad news though. I just wanted to see if anyone had any ideas or a > > direction to point us. We won't be able to get the bands without > > help from insurance. > > Here's the email from my wife: > > > > from Cranial tech just called. She said my insurance denied > > because it is an experimental procedure. She said that she will > send > > appeal papers, but with Blue Cross, once they deny something, they > > usually don't change their mind. She said they have a payment plan > > of 600.00 per month per child. She suggested we get on the > > internet. Said there are places that help with contributions. > Also > > said we may want to contact our State Representative. Quote Link to comment Share on other sites More sharing options...
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