Re: If you on on the fence about appealing PLEASE READ! GREAT NEWS!

[Guest guest]

ooooooo!!!!

I'm so gald to hear that you won your appeal. I hadn't heard from

you in awhile and was wondering how things have been going for you

and Jaxon. That must have been a wonderful feeling to open up the

mailbox and see 2 big whoppin checks. You have invested a lot of

time and money in getting Jaxon his treatment. Paying for 2 DOC

Bands and driving 6 hours roundtrip for adjustments. I'm so glad

they ended up covering them both.

a has finally left the Durham CT office. will be

there Mon-Wed. I was lucky to have them both there on the day

was casted. They are both great. I really enjoyed working

with a. However, I can already tell that I will enjoy going

to as well. I hope everything is going well for you and

Jaxon at the Charlotte CT.

I would love to see more pics!!!!

Dianna (Mom to , getting band 9/13)

In Plagiocephaly , " jdmtashrews " <JDMTAShrews@a...>

wrote:

> I just had to share my good news with someone. I haven't posted

much

> on the boards but I am a constant reader. I have learned so much

and

> I want to thank you all for that. This has been a LONG road but

one

> that I am so glad we are making to better our son's future. Our

son

> is Jaxon (he doesn't have a photo album yet but I will try to post

> one soon) and he will be 1 year on the 26th of this month. He was

> diagnosed with Plaigo at 6 months and his doctor didn't even

mention

> the tort but CT caught it and we started exercises. He went

through

> one band in about the normal 3 months and he is on his 2nd one

now.

> The results have been amazing. His numbers were cranial vault 24

and

> the first of August it was a 14 and his ear asymmetry was a 14 and

> the first of August a 10. I expect it is even better now. His

tort

> is almost resolved. It is noticeable anymore but they have

advised

> me to stretch him some still to keep it from coming back. We

started

> at the Durham CT but the therapist left and we switched to the

> Charlotte, NC office. We are adjusting, we live in VA and the

drive

> was 2 1/2 to Durham and is now 3 hours to Charlotte. Our

insurance

> decided they would not cover the first band in network so they

only

> paid $300 on it. It was horrible to make the $540 a month

payments

> to CT but we did. I was mad, I fought them when it was time for a

> 2nd band. I called them myself, explained that there was nowhere

we

> could take our son in network and could I please get an

exception.

> We were desperate, the thought of $540 a month for 5 more months

made

> me sick. CT called the insurance company over and over and

finally

> they agreed to cover the 2nd one in network. That made me happy

but

> we were still to see them pay the $300 they were supposed to pay

on

> the first band. So, I got worried and we decided to go ahead and

> send in an appeal for the first band. I got copies of every note

> Jaxon's Ped made on him and ever note from CT. I got copies of

all

> the pictures and even sent some of my own. I asked CT for help

and

> they gave me copies of law suit examples. Then we asked a friend

who

> works at an insurance company to help me write an appeal letter.

The

> insurance company which is Blue/Cross Blue Shield got it last

week.

> I went to my mailbox today and had 2 checks. Each for $3000.

THEY

> PAID! I went straight to the bank. Now I owe CT the $3000 for

the

> 2nd band and the $300 still from the first and the rest is ours.

I

> cannot begin to tell you how happy I am. PLEASE PLEASE if anyone

> needs help with an appeal letter, let me know and if you are

> wondering why bother, DO BOTHER, you owe your child the best care

and

> they will pay you just have to let them know who is boss.

Insurance

> is expensive and why pay into it if you can't even use it you

know?

> SORRY SO LONG but I just wanted to share the good news!

[Guest guest]

I LOVE your story...and am always frustrated with insurance. I was

lucky enough to be granted an out of network exception right off the

bat but am still waiting for the $$$$$.

Chalk one up for the good guys!!!!!

Dawn

> I just had to share my good news with someone. I haven't posted

much

> on the boards but I am a constant reader. I have learned so much

and

> I want to thank you all for that. This has been a LONG road but

one

> that I am so glad we are making to better our son's future. Our

son

> is Jaxon (he doesn't have a photo album yet but I will try to post

> one soon) and he will be 1 year on the 26th of this month. He was

> diagnosed with Plaigo at 6 months and his doctor didn't even

mention

> the tort but CT caught it and we started exercises. He went

through

> one band in about the normal 3 months and he is on his 2nd one

now.

> The results have been amazing. His numbers were cranial vault 24

and

> the first of August it was a 14 and his ear asymmetry was a 14 and

> the first of August a 10. I expect it is even better now. His

tort

> is almost resolved. It is noticeable anymore but they have

advised

> me to stretch him some still to keep it from coming back. We

started

> at the Durham CT but the therapist left and we switched to the

> Charlotte, NC office. We are adjusting, we live in VA and the

drive

> was 2 1/2 to Durham and is now 3 hours to Charlotte. Our

insurance

> decided they would not cover the first band in network so they

only

> paid $300 on it. It was horrible to make the $540 a month

payments

> to CT but we did. I was mad, I fought them when it was time for a

> 2nd band. I called them myself, explained that there was nowhere

we

> could take our son in network and could I please get an

exception.

> We were desperate, the thought of $540 a month for 5 more months

made

> me sick. CT called the insurance company over and over and

finally

> they agreed to cover the 2nd one in network. That made me happy

but

> we were still to see them pay the $300 they were supposed to pay

on

> the first band. So, I got worried and we decided to go ahead and

> send in an appeal for the first band. I got copies of every note

> Jaxon's Ped made on him and ever note from CT. I got copies of

all

> the pictures and even sent some of my own. I asked CT for help

and

> they gave me copies of law suit examples. Then we asked a friend

who

> works at an insurance company to help me write an appeal letter.

The

> insurance company which is Blue/Cross Blue Shield got it last

week.

> I went to my mailbox today and had 2 checks. Each for $3000.

THEY

> PAID! I went straight to the bank. Now I owe CT the $3000 for

the

> 2nd band and the $300 still from the first and the rest is ours.

I

> cannot begin to tell you how happy I am. PLEASE PLEASE if anyone

> needs help with an appeal letter, let me know and if you are

> wondering why bother, DO BOTHER, you owe your child the best care

and

> they will pay you just have to let them know who is boss.

Insurance

> is expensive and why pay into it if you can't even use it you

know?

> SORRY SO LONG but I just wanted to share the good news!

[Guest guest]

WOW-WEE! YAY YOU! Thanks for sharing your story. It always gets me

so angry to hear that ins. co.'s give us a hard time for the band.

Thank you for giving hope & advice to others!

Sue

Colin F. 11 mos.

STARband 6/29

Buffalo, NY

> I just had to share my good news with someone. I haven't posted

much

> on the boards but I am a constant reader. I have learned so much

and

> I want to thank you all for that. This has been a LONG road but

one

> that I am so glad we are making to better our son's future. Our

son

> is Jaxon (he doesn't have a photo album yet but I will try to post

> one soon) and he will be 1 year on the 26th of this month. He was

> diagnosed with Plaigo at 6 months and his doctor didn't even

mention

> the tort but CT caught it and we started exercises. He went

through

> one band in about the normal 3 months and he is on his 2nd one

now.

> The results have been amazing. His numbers were cranial vault 24

and

> the first of August it was a 14 and his ear asymmetry was a 14 and

> the first of August a 10. I expect it is even better now. His

tort

> is almost resolved. It is noticeable anymore but they have advised

> me to stretch him some still to keep it from coming back. We

started

> at the Durham CT but the therapist left and we switched to the

> Charlotte, NC office. We are adjusting, we live in VA and the

drive

> was 2 1/2 to Durham and is now 3 hours to Charlotte. Our insurance

> decided they would not cover the first band in network so they only

> paid $300 on it. It was horrible to make the $540 a month payments

> to CT but we did. I was mad, I fought them when it was time for a

> 2nd band. I called them myself, explained that there was nowhere

we

> could take our son in network and could I please get an exception.

> We were desperate, the thought of $540 a month for 5 more months

made

> me sick. CT called the insurance company over and over and finally

> they agreed to cover the 2nd one in network. That made me happy

but

> we were still to see them pay the $300 they were supposed to pay on

> the first band. So, I got worried and we decided to go ahead and

> send in an appeal for the first band. I got copies of every note

> Jaxon's Ped made on him and ever note from CT. I got copies of all

> the pictures and even sent some of my own. I asked CT for help and

> they gave me copies of law suit examples. Then we asked a friend

who

> works at an insurance company to help me write an appeal letter.

The

> insurance company which is Blue/Cross Blue Shield got it last

week.

> I went to my mailbox today and had 2 checks. Each for $3000. THEY

> PAID! I went straight to the bank. Now I owe CT the $3000 for the

> 2nd band and the $300 still from the first and the rest is ours. I

> cannot begin to tell you how happy I am. PLEASE PLEASE if anyone

> needs help with an appeal letter, let me know and if you are

> wondering why bother, DO BOTHER, you owe your child the best care

and

> they will pay you just have to let them know who is boss.

Insurance

> is expensive and why pay into it if you can't even use it you

know?

> SORRY SO LONG but I just wanted to share the good news!