Re: How long should we wait for insurance?

February 17, 2005

Hi , I personally didn't wait for insurance approval. was

5 months when he was casted. I didn't want to waste any precious

time, as you had said. It is good that I didn't wait because at the

end it would've taken 2 months. After the casting I kept calling the

insurance to see what was happening. CT first sent my insurance

something with missing info. So my insurance co sent it back...and

you know how long that must've taken. Then CT sent it back again. It

was a mess. I was glad I didn't wait. Even though now I paid $6000

out of pocket! At least started treatment nice and early. I

guess I have to look at it on the bright side since my pocket isn't

too happy about it! LOL.

Marcy and (10 months)in New Jersey

1 more week of Doc band #2 Brachycephaly

>

> Greetings,

>

> We finally got a prescription for a STAR band today! We have to

> wait a few weeks for the neuro to get the info to the ortho. The

> Ortho is going to send all the info to our insurance. So we are

> looking at at least a month before casting begins.

> I do expect our insurance to reject our claim, and i do plan on

> appealing.

> My question is how long should i wait for insurance to come

> through? OUr little guy is 6 1/2 months already and i dont want to

> waste precious time.

>

> How long did it take you? How easy was insurance?

>

> thanks for the help!

>

> emily vanden heuvel

> mommy of Elijah, 6 1/2 months, tort and plagio

> soon to be a STAR baby!

February 17, 2005

Hi ,

You need to find out the requirements from your insurance company.

Our company said they required a precertification, meaning they'd

give us an answer up front before casting. Their policy was that an

answer had to be given w/in 14 days. I could have had Hannah casted

w/out waiting for the precert, but then would have forfeited my

right to appeal. We were told we had to wait for the official word

(denial) and could have her casted right away, and go through the

appeals process while she was banded. We knew we'd band her despite

the outcome, so it was silly to waste any time. She was banded at

4.5 mos. We put the monthly payments on a zero interest credit card

while awaiting the decision. Good luck.

, mom to Hannah, DOCgrad

Cape Cod, Ma

http://hannahsnoggin.typepad.com

>

> Greetings,

>

> We finally got a prescription for a STAR band today! We have to

> wait a few weeks for the neuro to get the info to the ortho. The

> Ortho is going to send all the info to our insurance. So we are

> looking at at least a month before casting begins.

> I do expect our insurance to reject our claim, and i do plan on

> appealing.

> My question is how long should i wait for insurance to come

> through? OUr little guy is 6 1/2 months already and i dont want

to

> waste precious time.

>

> How long did it take you? How easy was insurance?

>

> thanks for the help!

>

> emily vanden heuvel

> mommy of Elijah, 6 1/2 months, tort and plagio

> soon to be a STAR baby!

February 17, 2005

HI ,

That is up to you. I personally wouldn't wait, the younger a baby is

banded the better and faster the correction.

>

> Greetings,

>

> We finally got a prescription for a STAR band today! We have to

> wait a few weeks for the neuro to get the info to the ortho. The

> Ortho is going to send all the info to our insurance. So we are

> looking at at least a month before casting begins.

> I do expect our insurance to reject our claim, and i do plan on

> appealing.

> My question is how long should i wait for insurance to come

> through? OUr little guy is 6 1/2 months already and i dont want to

> waste precious time.

>

> How long did it take you? How easy was insurance?

>

> thanks for the help!

>

> emily vanden heuvel

> mommy of Elijah, 6 1/2 months, tort and plagio

> soon to be a STAR baby!

February 17, 2005

As soon as we got the Rx, it was faxed to our ortho's office. The

ortho put it thru to ins. right away and it was denied within 48

hrs. We still made the scanning apptm't anyway (since we had the Rx)

and we charged the STARband on our Discover card. We appealed ins.

and eventually after about 1 mo. our denial was overturned and we

were reimbursed 50%. If you have the Rx, why does the ortho have to

wait for the neuro's consult letter (or whatever it is he is sending

the ortho)? That doesn't make sense to me. I would hope that things

could get underway right now. I have heard that you should at least

wait until you hear back from ins. so I would hope that your ortho

could do that now.

So it was only about 2 wks from the time of getting the Rx to

scanning (or casting if that is what you will do) and then 2 more wks

to get the band in for my son. Good luck!

Sue

Colin F. 16 mos.

STARband grad 9/04

(wore it from 9 mos to 12 mos old)

>

> Greetings,

>

> We finally got a prescription for a STAR band today! We have to

> wait a few weeks for the neuro to get the info to the ortho. The

> Ortho is going to send all the info to our insurance. So we are

> looking at at least a month before casting begins.

> I do expect our insurance to reject our claim, and i do plan on

> appealing.

> My question is how long should i wait for insurance to come

> through? OUr little guy is 6 1/2 months already and i dont want to

> waste precious time.

>

> How long did it take you? How easy was insurance?

>

> thanks for the help!

>

> emily vanden heuvel

> mommy of Elijah, 6 1/2 months, tort and plagio

> soon to be a STAR baby!

February 17, 2005

Hi ,

Our orthotist has people pay for the band up front ($2500) so we can get

everything

going right away (in case insurance takes a while or is denied). When the

insurance

comes through, then we are reimbursed.

Our insurance was painless. The ortho's secretary called them and asked what

their

policy was and was told about our 3 tier system of insurance (everything up to a

certain dollar amount, then we pay a deductable, then they pay up to 80% for all

non

standard things (standard would be check-ups, etc...). I " think " that the claim

was

through in about a week (my memory is a bit sketchy about exact time though--

sorry). It was really a non-issue.

If possible, I would not wait for insurance for too long. Kids grow at an

astounding

rate at that young age and you don't want to miss too many growth spurts. We

waited

to band until was 8.5 months old we missed some really good growth spurts.

--- In Plagiocephaly , " evandenheuvel " <evandenheuvel@y...>

wrote:

>

> Greetings,

>

> We finally got a prescription for a STAR band today! We have to

> wait a few weeks for the neuro to get the info to the ortho. The

> Ortho is going to send all the info to our insurance. So we are

> looking at at least a month before casting begins.

> I do expect our insurance to reject our claim, and i do plan on

> appealing.

> My question is how long should i wait for insurance to come

> through? OUr little guy is 6 1/2 months already and i dont want to

> waste precious time.

>

> How long did it take you? How easy was insurance?

>

> thanks for the help!

>

> emily vanden heuvel

> mommy of Elijah, 6 1/2 months, tort and plagio

> soon to be a STAR baby!

February 17, 2005

Hi ,

Our orthotist has people pay for the band up front ($2500) so we can get

everything

going right away (in case insurance takes a while or is denied). When the

insurance

comes through, then we are reimbursed.

Our insurance was painless. The ortho's secretary called them and asked what

their

policy was and was told about our 3 tier system of insurance (everything up to a

certain dollar amount, then we pay a deductable, then they pay up to 80% for all

non

standard things (standard would be check-ups, etc...). I " think " that the claim

was

through in about a week (my memory is a bit sketchy about exact time though--

sorry). It was really a non-issue.

If possible, I would not wait for insurance for too long. Kids grow at an

astounding

rate at that young age and you don't want to miss too many growth spurts. We

waited

to band until was 8.5 months old we missed some really good growth spurts.

--- In Plagiocephaly , " evandenheuvel " <evandenheuvel@y...>

wrote:

>

> Greetings,

>

> We finally got a prescription for a STAR band today! We have to

> wait a few weeks for the neuro to get the info to the ortho. The

> Ortho is going to send all the info to our insurance. So we are

> looking at at least a month before casting begins.

> I do expect our insurance to reject our claim, and i do plan on

> appealing.

> My question is how long should i wait for insurance to come

> through? OUr little guy is 6 1/2 months already and i dont want to

> waste precious time.

>

> How long did it take you? How easy was insurance?

>

> thanks for the help!

>

> emily vanden heuvel

> mommy of Elijah, 6 1/2 months, tort and plagio

> soon to be a STAR baby!

February 18, 2005

Hi

WHY in the world would it take the neuro place 1month to get some

paperwork to the ortho. If I was you I would try to hand carry it

over. That is such a waste of time.

Maybe you can call your insurance to see what the best way is to go

about this. Let us know how it all goes.

Sandy WIllow's Mom

Tort resolved

Cranio Germany Grad

http://www.geocities.com/samipa74/Willow_Lanette.html

>

> Greetings,

>

> We finally got a prescription for a STAR band today! We have to

> wait a few weeks for the neuro to get the info to the ortho. The

> Ortho is going to send all the info to our insurance. So we are

> looking at at least a month before casting begins.

> I do expect our insurance to reject our claim, and i do plan on

> appealing.

> My question is how long should i wait for insurance to come

> through? OUr little guy is 6 1/2 months already and i dont want

to

> waste precious time.

>

> How long did it take you? How easy was insurance?

>

> thanks for the help!

>

> emily vanden heuvel

> mommy of Elijah, 6 1/2 months, tort and plagio

> soon to be a STAR baby!

February 19, 2005

We didn't wait for insurance at all. I did call them before though

and asked if I could still appeal if I paid for the helmet before

they denied it. She said, " yes. " Then, when I went to get the

helmet after the casting, the billing person was on the phone with

the insurance company because she thought she found a loop hole.

But, because of billing codes, I was still going to be denied. So, I

paid out of pocket $1350 ( a 10% discount for paying all at once,

whoo, hoo!). But, when I got home and read the insurance company's

policy through, I found a specific note that said that my son's

helmet is covered because he had sagittal synostosis and also had

surgery for it. Anyway, I called the insurance company to see if

they received the claim yet (Fit-Well still billed them and would

reimburse me if insurance paid). They said they hadn't and it's been

2 weeks. So I had to fill out a claim form and fax it with the info

I had. I just did that today. We'll see how long that takes. So my

point is, this could take a long time, and if you can swing it, and

your insurance company doesn't have a rule about paying first, get

the helmet now and don't wait for insurance.

mum to Jack, sagittal surgery 1/13/05, now loving his Fit-Well helmet

>

> Greetings,

>

> We finally got a prescription for a STAR band today! We have to

> wait a few weeks for the neuro to get the info to the ortho. The

> Ortho is going to send all the info to our insurance. So we are

> looking at at least a month before casting begins.

> I do expect our insurance to reject our claim, and i do plan on

> appealing.

> My question is how long should i wait for insurance to come

> through? OUr little guy is 6 1/2 months already and i dont want to

> waste precious time.

>

> How long did it take you? How easy was insurance?

>

> thanks for the help!

>

> emily vanden heuvel

> mommy of Elijah, 6 1/2 months, tort and plagio

> soon to be a STAR baby!

February 19, 2005