Kaiser ? Anyone TIA need help w/ insurance ?

May 24, 2008

Hi Ladies,

I have a 8 1/2 month baby girl who was diagnosed with torticollis and

she's also a twin born 6 1/2 weeks early. She has plagio.

I asked for a referral from my pedi at about 4 months and got it

right away.

I took her first to a private practice who used a digital scan to

measure her which showed a 19mm degree of asymmetry .

Took her to Kaiser and visited with the cranio-facial specialist

team, they looked at her head-said there was no facial assymmetry,

and that helmets cause their own problems. They said to try

repositioning which we did.

Well, 3 months later-she is now at 19.2 mm asymmetry. So I went back

to the private practice and ordered the helmet yesterday because I

don't want to waste anymore time.

My questions are **If your insurance paid for it, what degree of

asymmetry did your baby have?

**Is it possible to get the insurance to cover if

they don't want to?

THANKS FOR ANY INSIGHT!!! It is much appreciated.

May 25, 2008

We had Kaiser in the San Francisco Bay area, and my daughter wore a

starband. It was covered 100% and she got it at 5 mo old (referred to

specialist at 4 mo). We saw Dr Menard in the Santa Clara office, and

he is definitely pro-banding. I'm not sure where you are located. He

is a cranio-facial plastic surgeon and very easy to talk to (but very

busy).

We were told coverage for banding depends on which level of coverage

your employer selected from Kaiser. I have another friend who saw the

same doc and her band was covered 90%. We were also told some Kaiser

plans dont' cover it at all.

If her plagio is as severe as you say (19mm) you should try and band

quickly. I hope you will get Kaiser to cover the cost. I know a

someone in LA (Jen, Luli's mom) who was referred to Hanger by Kaiser.

I guess it depends where you live and who they contract with. Who

ever you go with, make sure you check them out and that they have good

experience banding. We didn't do this ahead, but we lucky that our

ortho (CIRS in Palo Alto) was very good. It can make a big difference.

-christine

sydney 2 yrs starband grad

>

> Hi Ladies,

>

> I have a 8 1/2 month baby girl who was diagnosed with torticollis and

> she's also a twin born 6 1/2 weeks early. She has plagio.

> I asked for a referral from my pedi at about 4 months and got it

> right away.

>

> I took her first to a private practice who used a digital scan to

> measure her which showed a 19mm degree of asymmetry .

>

> Took her to Kaiser and visited with the cranio-facial specialist

> team, they looked at her head-said there was no facial assymmetry,

> and that helmets cause their own problems. They said to try

> repositioning which we did.

>

> Well, 3 months later-she is now at 19.2 mm asymmetry. So I went back

> to the private practice and ordered the helmet yesterday because I

> don't want to waste anymore time.

>

> My questions are **If your insurance paid for it, what degree of

> asymmetry did your baby have?

>

> **Is it possible to get the insurance to cover if

> they don't want to?

>

> THANKS FOR ANY INSIGHT!!! It is much appreciated.

>

May 27, 2008

We have Kaiser in Northern California and our band was covered at 80%. The

band was considered to be Durable Medical Equipment (DME) and the DME

coverage for the plan we have is 80%. We saw a plastic surgeon and he wrote

the prescription for the band which we then took to the local STARband

provider. My son measured 10 mm of asymmetry when the doctor wrote the

prescription.

Which Kaiser facility are you going to?

Molly

Novato, California