Guest guest Posted July 14, 2006 Report Share Posted July 14, 2006 Hi Everyone, I just got off the phone with UHC and we are approved for 's Starband. I'm shocked and so happy! I can't believe it. I just wanted to share the good news. Thank you for all your support! gets his band on 7/25 and has to wear it for 13 weeks. His measurements diagonial one side 147mm and the plagio side 122mm. The OT said that was pretty severe. Is it pretty severe? He also said he was 88%. Mom of andra-3 and 5 1/2 months plagio Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 14, 2006 Report Share Posted July 14, 2006 Congratulations on getting UHC to pay! Here are guidelines for measuring the severity of your child's head: Plagio Severity: Oblique at 30 deg (US1 and US2) = Length of diagonal taken at 30° on each side (30° corresponds to the corner of the eye). The subtraction of US1 and US2 gives an indication of the asymmetry of the head. normal 0-3 mm very mild <6 mm mild - 6-10 mm moderate - 10-15 mm severe - 15+ mm Brachycephaly Severity: Cephalic Ratio = Cranial Breadth/Cranial Length ideal ratio - 78% normal - 73-83% moderate - 83.1% to 87.9% severe - 88% + Molly California Nicolas, 9 months, tort & plagio, STARband 4/25/06 , 3 , 6.5 UHC-Approved us!!!! Hi Everyone, I just got off the phone with UHC and we are approved for 's Starband. I'm shocked and so happy! I can't believe it. I just wanted to share the good news. Thank you for all your support! gets his band on 7/25 and has to wear it for 13 weeks. His measurements diagonial one side 147mm and the plagio side 122mm. The OT said that was pretty severe. Is it pretty severe? He also said he was 88%. Mom of andra-3 and 5 1/2 months plagio For more plagio info Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 14, 2006 Report Share Posted July 14, 2006 Where did you locate these numbers? Thanks Blayne Rush, MHP, MBA Managing Partner Rush Search Partners, Ltd. 10633 W Elliot Dr. Ste D Frisco, TX 75034 469-385-7790 443-946-2439-Fax www.RushSearchPartners.com From: Plagiocephaly [mailto:Plagiocephaly ] On Behalf Of Foley, Molly Sent: Friday, July 14, 2006 10:46 AM Plagiocephaly Subject: SPAM-LOW: RE: UHC-Approved us!!!! Congratulations on getting UHC to pay! Here are guidelines for measuring the severity of your child's head: Plagio Severity: Oblique at 30 deg (US1 and US2) = Length of diagonal taken at 30° on each side (30° corresponds to the corner of the eye). The subtraction of US1 and US2 gives an indication of the asymmetry of the head. normal 0-3 mm very mild <6 mm mild - 6-10 mm moderate - 10-15 mm severe - 15+ mm Brachycephaly Severity: Cephalic Ratio = Cranial Breadth/Cranial Length ideal ratio - 78% normal - 73-83% moderate - 83.1% to 87.9% severe - 88% + Molly California Nicolas, 9 months, tort & plagio, STARband 4/25/06 , 3 , 6.5 UHC-Approved us!!!! Hi Everyone, I just got off the phone with UHC and we are approved for 's Starband. I'm shocked and so happy! I can't believe it. I just wanted to share the good news. Thank you for all your support! gets his band on 7/25 and has to wear it for 13 weeks. His measurements diagonial one side 147mm and the plagio side 122mm. The OT said that was pretty severe. Is it pretty severe? He also said he was 88%. Mom of andra-3 and 5 1/2 months plagio For more plagio info Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 14, 2006 Report Share Posted July 14, 2006 Congrats on the insurance approval!! And thank you for the measurements, Molly. Natasha > > Hi Everyone, > > I just got off the phone with UHC and we are approved for 's > Starband. I'm shocked and so happy! I can't believe it. > > I just wanted to share the good news. Thank you for all your support! > > gets his band on 7/25 and has to wear it for 13 weeks. His > measurements diagonial one side 147mm and the plagio side 122mm. The OT > said that was pretty severe. Is it pretty severe? He also said he was > 88%. > > > Mom of andra-3 and 5 1/2 months plagio > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 14, 2006 Report Share Posted July 14, 2006 Can these guidelines be found somewhere, in and article etc.? Would like to print and take to ped. office. RE: UHC-Approved us!!!! Congratulations on getting UHC to pay!Here are guidelines for measuring the severity of your child's head:Plagio Severity:Oblique at 30 deg (US1 and US2) = Length of diagonal taken at 30° on eachside (30° corresponds to the corner of the eye). The subtraction of US1 andUS2 gives an indication of the asymmetry of the head.normal 0-3 mmvery mild <6 mmmild - 6-10 mmmoderate - 10-15 mmsevere - 15+ mmBrachycephaly Severity:Cephalic Ratio = Cranial Breadth/Cranial Lengthideal ratio - 78%normal - 73-83%moderate - 83.1% to 87.9% severe - 88% +MollyCaliforniaNicolas, 9 months, tort & plagio, STARband 4/25/06, 3, 6.5-----Original Message-----From: Plagiocephaly [mailto:Plagiocephaly ]On Behalf Of jbattaglia090499Sent: 14 July 2006 6:11 AMPlagiocephaly Subject: UHC-Approved us!!!!Hi Everyone,I just got off the phone with UHC and we are approved for 's Starband. I'm shocked and so happy! I can't believe it. I just wanted to share the good news. Thank you for all your support! gets his band on 7/25 and has to wear it for 13 weeks. His measurements diagonial one side 147mm and the plagio side 122mm. The OT said that was pretty severe. Is it pretty severe? He also said he was 88%. Mom of andra-3 and 5 1/2 months plagioFor more plagio info Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 14, 2006 Report Share Posted July 14, 2006 , I am so glad for you! How on earth did you get approved over the phone? What was the reasoning? Did they have a certain code for billing? Does your policy have the orthotics exclusion? Did they ask about it being cosmetic or medical? It is CRAZY how they approve some and not others!! Glad to hear they will approve some of them! - Boise, ID Starting first appeal..... > > Hi Everyone, > > I just got off the phone with UHC and we are approved for 's > Starband. I'm shocked and so happy! I can't believe it. > > I just wanted to share the good news. Thank you for all your support! > > gets his band on 7/25 and has to wear it for 13 weeks. His > measurements diagonial one side 147mm and the plagio side 122mm. The OT > said that was pretty severe. Is it pretty severe? He also said he was > 88%. > > > Mom of andra-3 and 5 1/2 months plagio > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 15, 2006 Report Share Posted July 15, 2006 , I know you're being bombarded with questions, but what was UHC's reason for denail? Did you have to write an appeal letter? Thanks, Val From: "jbattaglia090499" <jbattag5@...>Reply-Plagiocephaly To: Plagiocephaly Subject: UHC-Approved us!!!!Date: Fri, 14 Jul 2006 13:11:02 -0000 Hi Everyone,I just got off the phone with UHC and we are approved for 's Starband. I'm shocked and so happy! I can't believe it. I just wanted to share the good news. Thank you for all your support! gets his band on 7/25 and has to wear it for 13 weeks. His measurements diagonial one side 147mm and the plagio side 122mm. The OT said that was pretty severe. Is it pretty severe? He also said he was 88%. Mom of andra-3 and 5 1/2 months plagio Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 15, 2006 Report Share Posted July 15, 2006 Yeah, congrats and thank you for sharing Sandy Willow's Mom Torticollis resolved Cranio germany grad 02/04 > > Hi Everyone, > > I just got off the phone with UHC and we are approved for 's > Starband. I'm shocked and so happy! I can't believe it. > > I just wanted to share the good news. Thank you for all your support! > > gets his band on 7/25 and has to wear it for 13 weeks. His > measurements diagonial one side 147mm and the plagio side 122mm. The OT > said that was pretty severe. Is it pretty severe? He also said he was > 88%. > > > Mom of andra-3 and 5 1/2 months plagio > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 15, 2006 Report Share Posted July 15, 2006 Yippeee! Wow a UHC approval is wonderful. The measurements you posted would give an assymmetry of 25mm which is very severe. I don't want to alarm you. He may be in it more than 13 weeks. He is at a great age to see good correction. He needs a lot of growth to correct. The 88% sounds like the Brachy measurement which isn't too bad. Good luck and let us know how the fitting goes. na, DOC Grad X2 Feb 04, Tort Resvoled Kiersten, DOC Grad April 06, Tort Resolved www.thefilyaws.com/plagio/plagio.html > > Hi Everyone, > > I just got off the phone with UHC and we are approved for 's > Starband. I'm shocked and so happy! I can't believe it. > > I just wanted to share the good news. Thank you for all your support! > > gets his band on 7/25 and has to wear it for 13 weeks. His > measurements diagonial one side 147mm and the plagio side 122mm. The OT > said that was pretty severe. Is it pretty severe? He also said he was > 88%. > > > Mom of andra-3 and 5 1/2 months plagio > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 17, 2006 Report Share Posted July 17, 2006 Hi Everyone, Everyone's been asking me how we got approved. Good question-I don't know. Here's all the info from my notes I've taken since I received the diagnosis from the Ped plastic surgeon. 6/9/06- We were diagnosised with moderate to severe plagio- rightsided. I did tell the Dr. that it was noticed at birth and the Pedi said it was probably the side he favored in utero. 6/9/06- I called UHC and told them he recieved a presciption for a cranial remolding helmet. The woman told me she need a diagnosis code: 754.0 for plagio and a billing code: S1040 (medical equip cranial remolding helmet. She said that UHC need to send this to the pre-determination dept for review to see if this was medical for a medical reason. She said to fax it over ASAP to reveiw the Dr's notes and make a decsion. 6/29/06- Notes were faxed to UHC from the Orthotics office from the Dr. 6/28/06- I called UHC to make sure the notes we under review. The woman said they had received the notes and it would take at least 5 days for review. 7/6/06- I called and the file was still under review. 7/10/06- I called before our appointment for scanning. Still no decsion. Added Urgent again to file. I receievd the case number for my records. She said to call back on Thurs or Fri. 7/13/06- I called to see if they had reached a decsion. YES-APPROVED! I hope this helps. I don't know if my son's case is very extreme or my husband's company (Clear Channel) has a better policy-but we were approved and will pay 95% of cost. We were never denied. Mom to andra-3 and 5 1/2 months Plagio Quote Link to comment Share on other sites More sharing options...
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