Guest guest Posted March 10, 2006 Report Share Posted March 10, 2006 Welcome! BC/BS has paid before if the flatness was present at birth as is the case with vacuum delivery, multiple births or premature birth...I have heard of them paying even under normal circumstances. I would dig deeper on that one. > > I'm new here and am so happy for this informational support. My son > is going to have a CT scan to determine the severity of his > Plagiocephaly. He is 4 months old. > > My Jack was delivered vacuum extraction. Could this be a possible > cause of his flat head? I'm sure that sleeping on his back has made > it worse, but has anyone been told that a flat head was caused by a > traumatic delivery? > > Also, I've spoken with Blue Cross Blue Shield and helmets and such are > considered cosmetic and therefore not covered. Any words of advice? > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 10, 2006 Report Share Posted March 10, 2006 Welcome! BC/BS has paid before if the flatness was present at birth as is the case with vacuum delivery, multiple births or premature birth...I have heard of them paying even under normal circumstances. I would dig deeper on that one. > > I'm new here and am so happy for this informational support. My son > is going to have a CT scan to determine the severity of his > Plagiocephaly. He is 4 months old. > > My Jack was delivered vacuum extraction. Could this be a possible > cause of his flat head? I'm sure that sleeping on his back has made > it worse, but has anyone been told that a flat head was caused by a > traumatic delivery? > > Also, I've spoken with Blue Cross Blue Shield and helmets and such are > considered cosmetic and therefore not covered. Any words of advice? > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 10, 2006 Report Share Posted March 10, 2006 BC/BS at least in Massachusetts covers the helmets up to $2,000 under the prostetic devise section. I called multiple times and got that confirmed twice. A coupple of people didn't know at first, they had to do research. > > > > I'm new here and am so happy for this informational support. My son > > is going to have a CT scan to determine the severity of his > > Plagiocephaly. He is 4 months old. > > > > My Jack was delivered vacuum extraction. Could this be a possible > > cause of his flat head? I'm sure that sleeping on his back has made > > it worse, but has anyone been told that a flat head was caused by a > > traumatic delivery? > > > > Also, I've spoken with Blue Cross Blue Shield and helmets and such are > > considered cosmetic and therefore not covered. Any words of advice? > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 10, 2006 Report Share Posted March 10, 2006 BC/BS at least in Massachusetts covers the helmets up to $2,000 under the prostetic devise section. I called multiple times and got that confirmed twice. A coupple of people didn't know at first, they had to do research. > > > > I'm new here and am so happy for this informational support. My son > > is going to have a CT scan to determine the severity of his > > Plagiocephaly. He is 4 months old. > > > > My Jack was delivered vacuum extraction. Could this be a possible > > cause of his flat head? I'm sure that sleeping on his back has made > > it worse, but has anyone been told that a flat head was caused by a > > traumatic delivery? > > > > Also, I've spoken with Blue Cross Blue Shield and helmets and such are > > considered cosmetic and therefore not covered. Any words of advice? > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 10, 2006 Report Share Posted March 10, 2006 Hi! I've seen that question about the vacuum extraction once before on this board, and it peaked my interest. I am certainly not qualified to say that's not a cause, but I don't understand how it would be. My first daughter was born prematurely, and a vaccum was used. It undoubtedly saved her life, as she was rushed to the NICU and didn't breathe on her own for 8 hours. But, 2 days later, she developed a large swollen lump on her head. Kind of freaked us out a little! Turned out to be fluid drawn to the area by the suction of the vacuum. In other words, we were led to believe that, if anything, the vaccum would result in the head " popping out " rather than developing flatness. I'm curious to hear what others know about the vacuum. My premature daughter born by vacuum had no torticollis or plagiocephaly. My second daughter, with the slighty more " normal " birth, had both. At least some of her plagio developed inutero based on her head shape and prenatal position, but it was made severe by her torticollis and excellent sleeping habits (22 hours a day!) for the first month or so. Also, Blue Cross Blue Shield of Colorado is paying for 2 bands with Cranial Technologies. We received full in-network benefits for an out- of-network provider. Pre-authorization was required, as was a letter of medical necessity (be sure to check the files and include all of the potential medical complications of untreated plagio) and a prescription stating " DOC Band, no substitutions " . Compared to the stories I've read here, ours was an extremely easy process. With the pre-authorization, they denied both claims, and made us wait almost 2 months for the check, but they finally paid the first one, and should be paying the second one next week. I'm holding my breath until I see the check, but with the pre-authorization they " have " to pay. Good luck to Jack! We started our band at 6 months, and today is graduation day! No more band as of tomorrow morning! We've seen unbelievably excellent results. If you decide to use a band, Jack is at a great age for great results! Tammy Teagan, less than 24 hours to Graduation! na, already picking out hair accessories for her sister's band free head! > > I'm new here and am so happy for this informational support. My son > is going to have a CT scan to determine the severity of his > Plagiocephaly. He is 4 months old. > > My Jack was delivered vacuum extraction. Could this be a possible > cause of his flat head? I'm sure that sleeping on his back has made > it worse, but has anyone been told that a flat head was caused by a > traumatic delivery? > > Also, I've spoken with Blue Cross Blue Shield and helmets and such are > considered cosmetic and therefore not covered. Any words of advice? > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 10, 2006 Report Share Posted March 10, 2006 Hi! I've seen that question about the vacuum extraction once before on this board, and it peaked my interest. I am certainly not qualified to say that's not a cause, but I don't understand how it would be. My first daughter was born prematurely, and a vaccum was used. It undoubtedly saved her life, as she was rushed to the NICU and didn't breathe on her own for 8 hours. But, 2 days later, she developed a large swollen lump on her head. Kind of freaked us out a little! Turned out to be fluid drawn to the area by the suction of the vacuum. In other words, we were led to believe that, if anything, the vaccum would result in the head " popping out " rather than developing flatness. I'm curious to hear what others know about the vacuum. My premature daughter born by vacuum had no torticollis or plagiocephaly. My second daughter, with the slighty more " normal " birth, had both. At least some of her plagio developed inutero based on her head shape and prenatal position, but it was made severe by her torticollis and excellent sleeping habits (22 hours a day!) for the first month or so. Also, Blue Cross Blue Shield of Colorado is paying for 2 bands with Cranial Technologies. We received full in-network benefits for an out- of-network provider. Pre-authorization was required, as was a letter of medical necessity (be sure to check the files and include all of the potential medical complications of untreated plagio) and a prescription stating " DOC Band, no substitutions " . Compared to the stories I've read here, ours was an extremely easy process. With the pre-authorization, they denied both claims, and made us wait almost 2 months for the check, but they finally paid the first one, and should be paying the second one next week. I'm holding my breath until I see the check, but with the pre-authorization they " have " to pay. Good luck to Jack! We started our band at 6 months, and today is graduation day! No more band as of tomorrow morning! We've seen unbelievably excellent results. If you decide to use a band, Jack is at a great age for great results! Tammy Teagan, less than 24 hours to Graduation! na, already picking out hair accessories for her sister's band free head! > > I'm new here and am so happy for this informational support. My son > is going to have a CT scan to determine the severity of his > Plagiocephaly. He is 4 months old. > > My Jack was delivered vacuum extraction. Could this be a possible > cause of his flat head? I'm sure that sleeping on his back has made > it worse, but has anyone been told that a flat head was caused by a > traumatic delivery? > > Also, I've spoken with Blue Cross Blue Shield and helmets and such are > considered cosmetic and therefore not covered. Any words of advice? > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 10, 2006 Report Share Posted March 10, 2006 Hi! My daughter was also delivered with the " vacume " . Our ortho said that it is not the cause but that it could have maybe pulled a muscle in her neck on one side during delivery thus causing her to turn her head to the opposite side. That was just a possibility though nothing for certain. Isabelle 7mos STARband 1/31/06 > > I'm new here and am so happy for this informational support. My son > is going to have a CT scan to determine the severity of his > Plagiocephaly. He is 4 months old. > > My Jack was delivered vacuum extraction. Could this be a possible > cause of his flat head? I'm sure that sleeping on his back has made > it worse, but has anyone been told that a flat head was caused by a > traumatic delivery? > > Also, I've spoken with Blue Cross Blue Shield and helmets and such are > considered cosmetic and therefore not covered. Any words of advice? > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 10, 2006 Report Share Posted March 10, 2006 Hi! My daughter was also delivered with the " vacume " . Our ortho said that it is not the cause but that it could have maybe pulled a muscle in her neck on one side during delivery thus causing her to turn her head to the opposite side. That was just a possibility though nothing for certain. Isabelle 7mos STARband 1/31/06 > > I'm new here and am so happy for this informational support. My son > is going to have a CT scan to determine the severity of his > Plagiocephaly. He is 4 months old. > > My Jack was delivered vacuum extraction. Could this be a possible > cause of his flat head? I'm sure that sleeping on his back has made > it worse, but has anyone been told that a flat head was caused by a > traumatic delivery? > > Also, I've spoken with Blue Cross Blue Shield and helmets and such are > considered cosmetic and therefore not covered. Any words of advice? > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 10, 2006 Report Share Posted March 10, 2006 Jack's Mom, This is the link for BC of CA, which you might be able to use. http://medpolicy.bluecrossca.com/policies/OR-PR/cranial_orthosis.html There should be a similar policy under your plan. Good luck, Amy Posner Mom to Ben, DOC grad 11/16 > > Also, I've spoken with Blue Cross Blue Shield and helmets and such are considered cosmetic and therefore not covered. Any words of advice? > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 10, 2006 Report Share Posted March 10, 2006 Jack's Mom, This is the link for BC of CA, which you might be able to use. http://medpolicy.bluecrossca.com/policies/OR-PR/cranial_orthosis.html There should be a similar policy under your plan. Good luck, Amy Posner Mom to Ben, DOC grad 11/16 > > Also, I've spoken with Blue Cross Blue Shield and helmets and such are considered cosmetic and therefore not covered. Any words of advice? > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 10, 2006 Report Share Posted March 10, 2006 fight with the insurance company, if the symetry of his head is off enough and the doctor is saying that is is medically necessary not it is not just for cosmetic reasons, they should cover it. good luck just keep on them > > I'm new here and am so happy for this informational support. My son > is going to have a CT scan to determine the severity of his > Plagiocephaly. He is 4 months old. > > My Jack was delivered vacuum extraction. Could this be a possible > cause of his flat head? I'm sure that sleeping on his back has made > it worse, but has anyone been told that a flat head was caused by a > traumatic delivery? > > Also, I've spoken with Blue Cross Blue Shield and helmets and such are > considered cosmetic and therefore not covered. Any words of advice? > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 10, 2006 Report Share Posted March 10, 2006 fight with the insurance company, if the symetry of his head is off enough and the doctor is saying that is is medically necessary not it is not just for cosmetic reasons, they should cover it. good luck just keep on them > > I'm new here and am so happy for this informational support. My son > is going to have a CT scan to determine the severity of his > Plagiocephaly. He is 4 months old. > > My Jack was delivered vacuum extraction. Could this be a possible > cause of his flat head? I'm sure that sleeping on his back has made > it worse, but has anyone been told that a flat head was caused by a > traumatic delivery? > > Also, I've spoken with Blue Cross Blue Shield and helmets and such are > considered cosmetic and therefore not covered. Any words of advice? > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 10, 2006 Report Share Posted March 10, 2006 My son is 6months old and is in Day 4 of his helmet. During his birth, I had pushed for 2 1/2 hrs not knowing he was face up and his head was banging upon my pelvis. Therefore he was born with a cephlahematoma and position changes did not help his lopsided head. We are slowly adjusting to the helmet. It seems to bother me more than him. With the next child I will demand an ultrasound to guarantee they are in the right position for birth. -'s Mom --- misquaredfbb <misquared@...> wrote: > fight with the insurance company, if the symetry of > his head is off > enough and the doctor is saying that is is medically > necessary not it > is not just for cosmetic reasons, they should cover > it. good luck > just keep on them > > > > > > I'm new here and am so happy for this > informational support. My son > > is going to have a CT scan to determine the > severity of his > > Plagiocephaly. He is 4 months old. > > > > My Jack was delivered vacuum extraction. Could > this be a possible > > cause of his flat head? I'm sure that sleeping on > his back has made > > it worse, but has anyone been told that a flat > head was caused by a > > traumatic delivery? > > > > Also, I've spoken with Blue Cross Blue Shield and > helmets and such > are > > considered cosmetic and therefore not covered. > Any words of advice? > > > > > > > > > > __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 10, 2006 Report Share Posted March 10, 2006 My son is 6months old and is in Day 4 of his helmet. During his birth, I had pushed for 2 1/2 hrs not knowing he was face up and his head was banging upon my pelvis. Therefore he was born with a cephlahematoma and position changes did not help his lopsided head. We are slowly adjusting to the helmet. It seems to bother me more than him. With the next child I will demand an ultrasound to guarantee they are in the right position for birth. -'s Mom --- misquaredfbb <misquared@...> wrote: > fight with the insurance company, if the symetry of > his head is off > enough and the doctor is saying that is is medically > necessary not it > is not just for cosmetic reasons, they should cover > it. good luck > just keep on them > > > > > > I'm new here and am so happy for this > informational support. My son > > is going to have a CT scan to determine the > severity of his > > Plagiocephaly. He is 4 months old. > > > > My Jack was delivered vacuum extraction. Could > this be a possible > > cause of his flat head? I'm sure that sleeping on > his back has made > > it worse, but has anyone been told that a flat > head was caused by a > > traumatic delivery? > > > > Also, I've spoken with Blue Cross Blue Shield and > helmets and such > are > > considered cosmetic and therefore not covered. > Any words of advice? > > > > > > > > > > __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 10, 2006 Report Share Posted March 10, 2006 Hi, I just wanted to direct you to a document in the Files section, if you haven't already read it. One of our moderators created a document called " 1st step for insurance, " and it is basically a step-by-step set of instructions on how to navigate the insurance coverage question all the way to how to address appeals based on the nature of denial. It includes insurance and diagnosis codes, too, if you don't know the ones specific to plagiocephaly and cranial banding. The codes are really invaluable when you are calling to first inquire about covereage. Just go to the Files section, Insurance Help folder, and scroll down to the document " 1st step for insurance. " Please let us know if that helps! Christie (Mom to Repo'd Remy) > > I'm new here and am so happy for this informational support. My son > is going to have a CT scan to determine the severity of his > Plagiocephaly. He is 4 months old. > > My Jack was delivered vacuum extraction. Could this be a possible > cause of his flat head? I'm sure that sleeping on his back has made > it worse, but has anyone been told that a flat head was caused by a > traumatic delivery? > > Also, I've spoken with Blue Cross Blue Shield and helmets and such are > considered cosmetic and therefore not covered. Any words of advice? > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 10, 2006 Report Share Posted March 10, 2006 Hi, I just wanted to direct you to a document in the Files section, if you haven't already read it. One of our moderators created a document called " 1st step for insurance, " and it is basically a step-by-step set of instructions on how to navigate the insurance coverage question all the way to how to address appeals based on the nature of denial. It includes insurance and diagnosis codes, too, if you don't know the ones specific to plagiocephaly and cranial banding. The codes are really invaluable when you are calling to first inquire about covereage. Just go to the Files section, Insurance Help folder, and scroll down to the document " 1st step for insurance. " Please let us know if that helps! Christie (Mom to Repo'd Remy) > > I'm new here and am so happy for this informational support. My son > is going to have a CT scan to determine the severity of his > Plagiocephaly. He is 4 months old. > > My Jack was delivered vacuum extraction. Could this be a possible > cause of his flat head? I'm sure that sleeping on his back has made > it worse, but has anyone been told that a flat head was caused by a > traumatic delivery? > > Also, I've spoken with Blue Cross Blue Shield and helmets and such are > considered cosmetic and therefore not covered. Any words of advice? > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 10, 2006 Report Share Posted March 10, 2006 BC/BS Illinois is covering 80% of $2000 of my son's DOC band. After we showed medical documentation of failed repositioning therapy for two months and of course the normal medical records and pictures and measurements from Cranial Technologies. Keep up the fight! > > > > > > I'm new here and am so happy for this informational support. My > son > > > is going to have a CT scan to determine the severity of his > > > Plagiocephaly. He is 4 months old. > > > > > > My Jack was delivered vacuum extraction. Could this be a > possible > > > cause of his flat head? I'm sure that sleeping on his back has > made > > > it worse, but has anyone been told that a flat head was caused > by a > > > traumatic delivery? > > > > > > Also, I've spoken with Blue Cross Blue Shield and helmets and > such are > > > considered cosmetic and therefore not covered. Any words of > advice? > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 10, 2006 Report Share Posted March 10, 2006 BC/BS Illinois is covering 80% of $2000 of my son's DOC band. After we showed medical documentation of failed repositioning therapy for two months and of course the normal medical records and pictures and measurements from Cranial Technologies. Keep up the fight! > > > > > > I'm new here and am so happy for this informational support. My > son > > > is going to have a CT scan to determine the severity of his > > > Plagiocephaly. He is 4 months old. > > > > > > My Jack was delivered vacuum extraction. Could this be a > possible > > > cause of his flat head? I'm sure that sleeping on his back has > made > > > it worse, but has anyone been told that a flat head was caused > by a > > > traumatic delivery? > > > > > > Also, I've spoken with Blue Cross Blue Shield and helmets and > such are > > > considered cosmetic and therefore not covered. Any words of > advice? > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 10, 2006 Report Share Posted March 10, 2006 Hi and welcome to the group. The vacuum extraction probably didn't cause the plagio but could have caused some neck trauma leading to tort and that lead to the plagio. BCBS in SC is covering my daughter DOC band. My company is self insured and dictates what is covered but uses Blue Choice SC to manage it. However, cranial orthosis are not cosmetic. Here is a place to start for your appeal ... 1st step for Insurance.doc Insurance Help - where to start na, DOC Grad Feb 04, Tort ResolvedKiersten, DOC Band 1/10/06, Tortwww.thefilyaws.com/plagio/plagio.html>> I'm new here and am so happy for this informational support. My son > is going to have a CT scan to determine the severity of his > Plagiocephaly. He is 4 months old.> > My Jack was delivered vacuum extraction. Could this be a possible > cause of his flat head? I'm sure that sleeping on his back has made > it worse, but has anyone been told that a flat head was caused by a > traumatic delivery?> > Also, I've spoken with Blue Cross Blue Shield and helmets and such are > considered cosmetic and therefore not covered. Any words of advice?> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 10, 2006 Report Share Posted March 10, 2006 Hi and welcome to the group. The vacuum extraction probably didn't cause the plagio but could have caused some neck trauma leading to tort and that lead to the plagio. BCBS in SC is covering my daughter DOC band. My company is self insured and dictates what is covered but uses Blue Choice SC to manage it. However, cranial orthosis are not cosmetic. Here is a place to start for your appeal ... 1st step for Insurance.doc Insurance Help - where to start na, DOC Grad Feb 04, Tort ResolvedKiersten, DOC Band 1/10/06, Tortwww.thefilyaws.com/plagio/plagio.html>> I'm new here and am so happy for this informational support. My son > is going to have a CT scan to determine the severity of his > Plagiocephaly. He is 4 months old.> > My Jack was delivered vacuum extraction. Could this be a possible > cause of his flat head? I'm sure that sleeping on his back has made > it worse, but has anyone been told that a flat head was caused by a > traumatic delivery?> > Also, I've spoken with Blue Cross Blue Shield and helmets and such are > considered cosmetic and therefore not covered. Any words of advice?> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 10, 2006 Report Share Posted March 10, 2006 I was reading the policy and thinking wow that is very rational and fair ... then I got to the brachy statement - ergh. So close but still clueless. na, DOC Grad Feb 04, Tort Resolved Kiersten, DOC Band 1/10/06, Tort www.thefilyaws.com/plagio/plagio.html > > > > Also, I've spoken with Blue Cross Blue Shield and helmets and such > are considered cosmetic and therefore not covered. Any words of > advice? > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 10, 2006 Report Share Posted March 10, 2006 I was reading the policy and thinking wow that is very rational and fair ... then I got to the brachy statement - ergh. So close but still clueless. na, DOC Grad Feb 04, Tort Resolved Kiersten, DOC Band 1/10/06, Tort www.thefilyaws.com/plagio/plagio.html > > > > Also, I've spoken with Blue Cross Blue Shield and helmets and such > are considered cosmetic and therefore not covered. Any words of > advice? > > > Quote Link to comment Share on other sites More sharing options...
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