Re: Kaiser Insurance Coverage

[Guest guest]

Miriam,

I don't understand the lingo either but I'll tell you that both DOC bands that Maysa wore were covered 100% by Kaiser. I just had to get a referral from her ped who wasn't willing to write her one but who ended up doing it anyway. The second DOC band was first denied, but after a few phone calls and some documentation about Maysa's progress it was accepted.

Good luck,

Leila,Maysa, 19 mo, DOC band Grad 5.26.09

www.mymaysa.wordpress.com

From: miriamsumner <miriamsumner@...>Subject: Kaiser Insurance CoveragePlagiocephaly Date: Friday, August 14, 2009, 1:40 PM

So I'm looking at the insurance coverage information on kp.org, but I don't understand the lingo. Can anyone help me figure out if we will be covered for the helmet if we need one?Here's what it says on kp.org:Durable Medical Equipment/Orthotics DME Basic Healthplan List - No Payment DME Knox Keene Mandated Items - No Payment Durable Medical Equipment Formulary - Not Covered P & O Basic Healthplan List - No Payment P & O Base Knox Keene Mandated Items - No Payment Prosthetic and Orthotic Formulary - Not Covered Do I just have to call and ask? Will it be a STARband with CIRS? I can't find a website for CIRS. Thanks.Miriam

[Guest guest]

I would just call and ask them. They'll be able to look at the plan you

have and tell you exactly what is covered. If Kaiser does cover the band

they will only cover it if you go to CIRS. We have a Hanger facility 5

minutes away from us so I called to see if they would cover a Hanger band

and they would not. Someone else I know in town flew down to L.A. for a

DOCband and they would not cover that either.

Molly

Novato, California

Nicolas, 3.5, tort & plagio, STARband (CIRS Oakland) 4/24/06-9/12/06,

Graduate!

, 6, 9.5

Kaiser Insurance Coverage

So I'm looking at the insurance coverage information on kp.org, but I don't

understand the lingo. Can anyone help me figure out if we will be covered

for the helmet if we need one?

Here's what it says on kp.org:

Durable Medical Equipment/Orthotics

DME Basic Healthplan List - No Payment

DME Knox Keene Mandated Items - No Payment

Durable Medical Equipment Formulary - Not Covered

P & O Basic Healthplan List - No Payment

P & O Base Knox Keene Mandated Items - No Payment

Prosthetic and Orthotic Formulary - Not Covered

Do I just have to call and ask? Will it be a STARband with CIRS? I can't

find a website for CIRS.

Thanks.

Miriam

------------------------------------

For more plagio info

[Guest guest]

CIRS is a pretty good place? The Oakland location will work well for us since

we live in Hayward.

I was reading about STARbands, about how they don't require training so we have

to do research on our own.

I don't plan to do the DOCband. Not going to drive to LA every few weeks!

>

> I would just call and ask them. They'll be able to look at the plan you

> have and tell you exactly what is covered. If Kaiser does cover the band

> they will only cover it if you go to CIRS. We have a Hanger facility 5

> minutes away from us so I called to see if they would cover a Hanger band

> and they would not. Someone else I know in town flew down to L.A. for a

> DOCband and they would not cover that either.

>

> Molly

> Novato, California

> Nicolas, 3.5, tort & plagio, STARband (CIRS Oakland) 4/24/06-9/12/06,

> Graduate!

> , 6, 9.5

>

> Kaiser Insurance Coverage

>

> So I'm looking at the insurance coverage information on kp.org, but I don't

> understand the lingo. Can anyone help me figure out if we will be covered

> for the helmet if we need one?

>

> Here's what it says on kp.org:

>

> Durable Medical Equipment/Orthotics

>

> DME Basic Healthplan List - No Payment

> DME Knox Keene Mandated Items - No Payment

> Durable Medical Equipment Formulary - Not Covered

> P & O Basic Healthplan List - No Payment

> P & O Base Knox Keene Mandated Items - No Payment

> Prosthetic and Orthotic Formulary - Not Covered

>

>

> Do I just have to call and ask? Will it be a STARband with CIRS? I can't

> find a website for CIRS.

>

> Thanks.

> Miriam

>

>

>

> ------------------------------------

>

> For more plagio info

[Guest guest]

We went to CIRS in Oakland and had a great experience and great results. We

saw Trish and really liked her. I think you will be in good hands with her.

Molly

Novato, California

Nicolas, 3.5, tort & plagio, STARband (CIRS Oakland) 4/24/06-9/12/06,

Graduate!

, 6

, 9.5

Kaiser Insurance Coverage

>

> So I'm looking at the insurance coverage information on kp.org, but I

don't

> understand the lingo. Can anyone help me figure out if we will be covered

> for the helmet if we need one?

>

> Here's what it says on kp.org:

>

> Durable Medical Equipment/Orthotics

>

> DME Basic Healthplan List - No Payment

> DME Knox Keene Mandated Items - No Payment

> Durable Medical Equipment Formulary - Not Covered

> P & O Basic Healthplan List - No Payment

> P & O Base Knox Keene Mandated Items - No Payment

> Prosthetic and Orthotic Formulary - Not Covered

>

>

> Do I just have to call and ask? Will it be a STARband with CIRS? I can't

> find a website for CIRS.

>

> Thanks.

> Miriam

>

>

>

> ------------------------------------

>

> For more plagio info

[Guest guest]

Okay well I just called, and they couldn't find the band on their list. Does

anybody know what is the technial/medical name of the helmet? The lady on the

phone checked under cranial, plagio, helmet, STARband, and nothing.

I only have the basic coverage, which may mean that I will not be covered for

the helmet.

I guess there really is not point on finding out if I'm cover or not, since I'm

pretty sure I really want it. But if it is covered, then there is no reason for

NOT getting it.

I'm still waiting for Dr. Menard to get back to me .

> >

> > I would just call and ask them. They'll be able to look at the plan you

> > have and tell you exactly what is covered. If Kaiser does cover the band

> > they will only cover it if you go to CIRS. We have a Hanger facility 5

> > minutes away from us so I called to see if they would cover a Hanger band

> > and they would not. Someone else I know in town flew down to L.A. for a

> > DOCband and they would not cover that either.

> >

> > Molly

> > Novato, California

> > Nicolas, 3.5, tort & plagio, STARband (CIRS Oakland) 4/24/06-9/12/06,

> > Graduate!

> > , 6, 9.5

> >

> > Kaiser Insurance Coverage

> >

> > So I'm looking at the insurance coverage information on kp.org, but I don't

> > understand the lingo. Can anyone help me figure out if we will be covered

> > for the helmet if we need one?

> >

> > Here's what it says on kp.org:

> >

> > Durable Medical Equipment/Orthotics

> >

> > DME Basic Healthplan List - No Payment

> > DME Knox Keene Mandated Items - No Payment

> > Durable Medical Equipment Formulary - Not Covered

> > P & O Basic Healthplan List - No Payment

> > P & O Base Knox Keene Mandated Items - No Payment

> > Prosthetic and Orthotic Formulary - Not Covered

> >

> >

> > Do I just have to call and ask? Will it be a STARband with CIRS? I can't

> > find a website for CIRS.

> >

> > Thanks.

> > Miriam

> >

> >

> >

> > ------------------------------------

> >

> > For more plagio info

[Guest guest]

Try using the code S1040. It's the cranial remolding orthosis. That's what UHC

uses and I think it's standard regardless of your carrier.

> > >

> > > I would just call and ask them. They'll be able to look at the plan you

> > > have and tell you exactly what is covered. If Kaiser does cover the band

> > > they will only cover it if you go to CIRS. We have a Hanger facility 5

> > > minutes away from us so I called to see if they would cover a Hanger band

> > > and they would not. Someone else I know in town flew down to L.A. for a

> > > DOCband and they would not cover that either.

> > >

> > > Molly

> > > Novato, California

> > > Nicolas, 3.5, tort & plagio, STARband (CIRS Oakland) 4/24/06-9/12/06,

> > > Graduate!

> > > , 6, 9.5

> > >

> > > Kaiser Insurance Coverage

> > >

> > > So I'm looking at the insurance coverage information on kp.org, but I

don't

> > > understand the lingo. Can anyone help me figure out if we will be covered

> > > for the helmet if we need one?

> > >

> > > Here's what it says on kp.org:

> > >

> > > Durable Medical Equipment/Orthotics

> > >

> > > DME Basic Healthplan List - No Payment

> > > DME Knox Keene Mandated Items - No Payment

> > > Durable Medical Equipment Formulary - Not Covered

> > > P & O Basic Healthplan List - No Payment

> > > P & O Base Knox Keene Mandated Items - No Payment

> > > Prosthetic and Orthotic Formulary - Not Covered

> > >

> > >

> > > Do I just have to call and ask? Will it be a STARband with CIRS? I can't

> > > find a website for CIRS.

> > >

> > > Thanks.

> > > Miriam

> > >

> > >

> > >

> > > ------------------------------------

> > >

> > > For more plagio info

[Guest guest]

Well I asked her to search under " cranial " and got nothing.

I already sent an email to the doc, hopefully he'll get back to me soon. I just

want to get the ball rolling.

Do you know how long it takes from the first visit to the helmet place (CIRS) to

the first fitting? They do an electronic scan.

> > > >

> > > > I would just call and ask them. They'll be able to look at the plan you

> > > > have and tell you exactly what is covered. If Kaiser does cover the

band

> > > > they will only cover it if you go to CIRS. We have a Hanger facility 5

> > > > minutes away from us so I called to see if they would cover a Hanger

band

> > > > and they would not. Someone else I know in town flew down to L.A. for a

> > > > DOCband and they would not cover that either.

> > > >

> > > > Molly

> > > > Novato, California

> > > > Nicolas, 3.5, tort & plagio, STARband (CIRS Oakland) 4/24/06-9/12/06,

> > > > Graduate!

> > > > , 6, 9.5

> > > >

> > > > Kaiser Insurance Coverage

> > > >

> > > > So I'm looking at the insurance coverage information on kp.org, but I

don't

> > > > understand the lingo. Can anyone help me figure out if we will be

covered

> > > > for the helmet if we need one?

> > > >

> > > > Here's what it says on kp.org:

> > > >

> > > > Durable Medical Equipment/Orthotics

> > > >

> > > > DME Basic Healthplan List - No Payment

> > > > DME Knox Keene Mandated Items - No Payment

> > > > Durable Medical Equipment Formulary - Not Covered

> > > > P & O Basic Healthplan List - No Payment

> > > > P & O Base Knox Keene Mandated Items - No Payment

> > > > Prosthetic and Orthotic Formulary - Not Covered

> > > >

> > > >

> > > > Do I just have to call and ask? Will it be a STARband with CIRS? I

can't

> > > > find a website for CIRS.

> > > >

> > > > Thanks.

> > > > Miriam

> > > >

> > > >

> > > >

> > > > ------------------------------------

> > > >

> > > > For more plagio info

[Guest guest]

I just got a reply from Dr. Menard:

Indeed your plan does not cover the $3000 helmet. You are free to pursue the

helmet at CIRS if you wish, but, with several publications on the subject, 11

years of experience, and having seen thousands of infants for this issue, I can

tell you that the amount of change that you will see if you choose to get the

helmet will be minimal. Your pediatrician can write you a prescription for the

helmet if you wish, and I have cc'd her on this message. Time and growth will

help resolve the 5mm of asymmetry that I measured yesterday, but the occipital

contour that you are concerned about may indeed be her genetically determined

head shape, and the helmet would do little to address that.

I'm not sure if he feels disrespected, that is why he listed his qualification

(publications, experience, etc.). By no means was I trying to disrespect him,

but as a first time mom, I worry about EVERY. LITTLE. THING. I don't understand

why it will help round out other babies' heads but not mine! Is her situation

not as bad as I see it? (I emailed him back asking him to explain to me why it

won't help, since the band will force her skull to grow a certain direction.)

I'm definitely going to try and take some profile pictures this week and post

them up so you all can take a look.

> > > >

> > > > I would just call and ask them. They'll be able to look at the plan you

> > > > have and tell you exactly what is covered. If Kaiser does cover the

band

> > > > they will only cover it if you go to CIRS. We have a Hanger facility 5

> > > > minutes away from us so I called to see if they would cover a Hanger

band

> > > > and they would not. Someone else I know in town flew down to L.A. for a

> > > > DOCband and they would not cover that either.

> > > >

> > > > Molly

> > > > Novato, California

> > > > Nicolas, 3.5, tort & plagio, STARband (CIRS Oakland) 4/24/06-9/12/06,

> > > > Graduate!

> > > > , 6, 9.5

> > > >

> > > > Kaiser Insurance Coverage

> > > >

> > > > So I'm looking at the insurance coverage information on kp.org, but I

don't

> > > > understand the lingo. Can anyone help me figure out if we will be

covered

> > > > for the helmet if we need one?

> > > >

> > > > Here's what it says on kp.org:

> > > >

> > > > Durable Medical Equipment/Orthotics

> > > >

> > > > DME Basic Healthplan List - No Payment

> > > > DME Knox Keene Mandated Items - No Payment

> > > > Durable Medical Equipment Formulary - Not Covered

> > > > P & O Basic Healthplan List - No Payment

> > > > P & O Base Knox Keene Mandated Items - No Payment

> > > > Prosthetic and Orthotic Formulary - Not Covered

> > > >

> > > >

> > > > Do I just have to call and ask? Will it be a STARband with CIRS? I

can't

> > > > find a website for CIRS.

> > > >

> > > > Thanks.

> > > > Miriam

> > > >

> > > >

> > > >

> > > > ------------------------------------

> > > >

> > > > For more plagio info

[Guest guest]

The band is made by Orthomerica so perhaps they can check under that name.

Can you ask the rep if you have DME coverage and if so, what percentage?

Molly

Novato, California

Nicolas, 3.5, tort & plagio, STARband (CIRS Oakland) 4/24/06-9/12/06,

Graduate!

, 6.5

, 9.5

Kaiser Insurance Coverage

> >

> > So I'm looking at the insurance coverage information on kp.org, but I

don't

> > understand the lingo. Can anyone help me figure out if we will be

covered

> > for the helmet if we need one?

> >

> > Here's what it says on kp.org:

> >

> > Durable Medical Equipment/Orthotics

> >

> > DME Basic Healthplan List - No Payment

> > DME Knox Keene Mandated Items - No Payment

> > Durable Medical Equipment Formulary - Not Covered

> > P & O Basic Healthplan List - No Payment

> > P & O Base Knox Keene Mandated Items - No Payment

> > Prosthetic and Orthotic Formulary - Not Covered

> >

> >

> > Do I just have to call and ask? Will it be a STARband with CIRS? I

can't

> > find a website for CIRS.

> >

> > Thanks.

> > Miriam

> >

> >

> >

> > ------------------------------------

> >

> > For more plagio info

[Guest guest]

You will receive your band in less than two weeks. That is the standard

among all band companies - that you shouldn't go longer than two weeks

between the time you get measured and the time you get the band and fitted.

I think when we got ours we got it 10 days later which was partially due to

my schedule, I was on vacation and could not get in any sooner.

Molly

Novato, California

Nicolas, 3.5, tort & plagio, STARband (CIRS Oakland) 4/24/06-9/12/06,

Graduate!

, 6.5

, 9.5

Kaiser Insurance Coverage

> > > >

> > > > So I'm looking at the insurance coverage information on kp.org, but

I don't

> > > > understand the lingo. Can anyone help me figure out if we will be

covered

> > > > for the helmet if we need one?

> > > >

> > > > Here's what it says on kp.org:

> > > >

> > > > Durable Medical Equipment/Orthotics

> > > >

> > > > DME Basic Healthplan List - No Payment

> > > > DME Knox Keene Mandated Items - No Payment

> > > > Durable Medical Equipment Formulary - Not Covered

> > > > P & O Basic Healthplan List - No Payment

> > > > P & O Base Knox Keene Mandated Items - No Payment

> > > > Prosthetic and Orthotic Formulary - Not Covered

> > > >

> > > >

> > > > Do I just have to call and ask? Will it be a STARband with CIRS? I

can't

> > > > find a website for CIRS.

> > > >

> > > > Thanks.

> > > > Miriam

> > > >

> > > >

> > > >

> > > > ------------------------------------

> > > >

> > > > For more plagio info

[Guest guest]

Wow, I can't believe he said that! I would definitely go to CIRS for an

evaluation, if nothing else for some peace of mind. The scan they do is

pretty amazing and you can see a nice 3-D picture of your child's head.

When we saw ours for the first time I couldn't believe how flat my son's

head was. He had a lot of hair which hid it well. Have you called CIRS yet

to make an appointment?

Molly

Novato, California

Nicolas, 3.5, tort & plagio, STARband (CIRS Oakland) 4/24/06-9/12/06,

Graduate!

, 6.5

, 9.5

Kaiser Insurance Coverage

> > > >

> > > > So I'm looking at the insurance coverage information on kp.org, but

I don't

> > > > understand the lingo. Can anyone help me figure out if we will be

covered

> > > > for the helmet if we need one?

> > > >

> > > > Here's what it says on kp.org:

> > > >

> > > > Durable Medical Equipment/Orthotics

> > > >

> > > > DME Basic Healthplan List - No Payment

> > > > DME Knox Keene Mandated Items - No Payment

> > > > Durable Medical Equipment Formulary - Not Covered

> > > > P & O Basic Healthplan List - No Payment

> > > > P & O Base Knox Keene Mandated Items - No Payment

> > > > Prosthetic and Orthotic Formulary - Not Covered

> > > >

> > > >

> > > > Do I just have to call and ask? Will it be a STARband with CIRS? I

can't

> > > > find a website for CIRS.

> > > >

> > > > Thanks.

> > > > Miriam

> > > >

> > > >

> > > >

> > > > ------------------------------------

> > > >

> > > > For more plagio info

[Guest guest]

I'm concerned that he must be focusing too much on the asymmetry, as 5mm is

rather mild for plagio (though my son graduated with that amount and I can still

see it, so I'm not brushing it off, I can just see where he may be coming from).

However, from the profile photo links you posted earlier, it looks like the main

concern should be brachy, right? Or am I not seeing things correctly? (the

photos are rather dark, but I could still make out the flatness without much

trouble). Did he measure for that? That number is a percentage ( " normal " would

be somewhere in the 80s) and is called the cranial vault index. That would be an

important number to know. CIRS could give you that number/measurement if you go

for an eval.

Do you think your ped would write the prescription for you?

Jake-2.5 (DOCBand Grad 9/08)

Jordan-5

> > > > >

> > > > > I would just call and ask them. They'll be able to look at the plan

you

> > > > > have and tell you exactly what is covered. If Kaiser does cover the

band

> > > > > they will only cover it if you go to CIRS. We have a Hanger facility

5

> > > > > minutes away from us so I called to see if they would cover a Hanger

band

> > > > > and they would not. Someone else I know in town flew down to L.A. for

a

> > > > > DOCband and they would not cover that either.

> > > > >

> > > > > Molly

> > > > > Novato, California

> > > > > Nicolas, 3.5, tort & plagio, STARband (CIRS Oakland) 4/24/06-9/12/06,

> > > > > Graduate!

> > > > > , 6, 9.5

> > > > >

> > > > > Kaiser Insurance Coverage

> > > > >

> > > > > So I'm looking at the insurance coverage information on kp.org, but I

don't

> > > > > understand the lingo. Can anyone help me figure out if we will be

covered

> > > > > for the helmet if we need one?

> > > > >

> > > > > Here's what it says on kp.org:

> > > > >

> > > > > Durable Medical Equipment/Orthotics

> > > > >

> > > > > DME Basic Healthplan List - No Payment

> > > > > DME Knox Keene Mandated Items - No Payment

> > > > > Durable Medical Equipment Formulary - Not Covered

> > > > > P & O Basic Healthplan List - No Payment

> > > > > P & O Base Knox Keene Mandated Items - No Payment

> > > > > Prosthetic and Orthotic Formulary - Not Covered

> > > > >

> > > > >

> > > > > Do I just have to call and ask? Will it be a STARband with CIRS? I

can't

> > > > > find a website for CIRS.

> > > > >

> > > > > Thanks.

> > > > > Miriam

> > > > >

> > > > >

> > > > >

> > > > > ------------------------------------

> > > > >

> > > > > For more plagio info

[Guest guest]

HI Miriam,We live in Palo ALto and our Kaiser plan covered all expenses with helmet. My son has microtia and we did see  Dr. Menard  in Santa Clara hospital. He is really great doctor and good person. I am first time mother as well and 's condition was big surprise for us. When we visited Dr. Menard's office,he was really supportive and it was him,who recommended  helmet for 's head. 's measurement was 16mm. His head should be in helmet until the measurement is  under 10mm.Doben & / 9 month /From: miriamsumner <miriamsumner@...>Subject: Re:

Kaiser Insurance CoveragePlagiocephaly Date: Friday, August 14, 2009, 11:02 PMI just got a reply from Dr. Menard:Indeed your plan does not cover the $3000 helmet. You are free to pursue the helmet at CIRS if you wish, but, with several publications on the subject, 11 years of experience, and having seen thousands of infants for this issue, I can tell you that the amount of change that you will see if you choose to get the helmet will be minimal. Your pediatrician can write you a prescription for the helmet if you wish, and I have cc'd her on this message. Time and growth will help resolve the 5mm of asymmetry that I measured yesterday, but the occipital contour that you are concerned about may indeed be her genetically determined head shape, and the helmet would do little to address that.I'm not sure if he feels disrespected, that is why he listed his qualification

(publications, experience, etc.).  By no means was I trying to disrespect him, but as a first time mom, I worry about EVERY. LITTLE. THING.  I don't understand why it will help round out other babies' heads but not mine!  Is her situation not as bad as I see it?  (I emailed him back asking him to explain to me why it won't help, since the band will force her skull to grow a certain direction.)I'm definitely going to try and take some profile pictures this week and post them up so you all can take a look.> > > >> > > > I would just call and ask them.  They'll be able to look at the plan you> > > > have and tell you exactly what is covered.  If Kaiser does cover the band> > > > they will only cover it if you go to CIRS.  We have a Hanger facility 5> > > > minutes away from us so I called to see if they would cover a Hanger band> > > > and they would not.  Someone else I know in town flew down to L.A. for a> > > > DOCband

and they would not cover that either.> > > > > > > > Molly> > > > Novato, California> > > > Nicolas, 3.5, tort & plagio, STARband (CIRS Oakland) 4/24/06-9/12/06,> > > > Graduate!> > > > , 6, 9.5> > > > > > > > Kaiser Insurance Coverage> > > > > > > > So I'm looking at the insurance coverage information on kp.org, but I

don't> > > > understand the lingo.  Can anyone help me figure out if we will be covered> > > > for the helmet if we need one?> > > > > > > > Here's what it says on kp.org:> > > > > > > > Durable Medical Equipment/Orthotics > > > > > > > > DME Basic Healthplan List - No Payment > > > > DME Knox Keene Mandated Items - No Payment > > > > Durable Medical Equipment Formulary - Not Covered > > > > P & O Basic Healthplan List - No Payment > > > > P & O Base Knox Keene Mandated Items - No Payment > > > > Prosthetic and Orthotic Formulary - Not Covered > > > > > > > > > > > > Do I just have to call and ask?  Will it be a STARband with CIRS?  I can't> > > > find a website for CIRS.  > > > > > > > > Thanks.> > > > Miriam> > > > > > > > > > > > > > > > ------------------------------------> > > > > > > > For more plagio info, go to

www.plagiocephaly.org/support > > > >

[Guest guest]

hi everyone. I contacted Cranial Technologies of AZ today becuase the office closest to me is closed until monday My closest office is Clinton CA. the website for cranial just boggles my mind at this pt. so i am trying to get as much info as i can before monday. i will be in the chat at 10pm tonite. but would love any recommendations as to how to proceed. is it ok that i dont go back to hanger again? and proceed with Cranial? how many of you have used cranial? and had your insurance cover it? vs not cover it and pay the 3600

[Guest guest]

Hi,

You might want to try my baby's chiropractor.

Dr. Kerri

Felton,CA

831-335-9300

She was recommended to me by another chiropractor. She has training in

pediatric chiro care. In fact, she teaches a class in pediatrics at a

chiropractor school. She is SO nice. I swear she has helped my baby's

head shape. She might tell you her opinion of the helmet for your

baby. She thought it was a good idea for my son and has seen how it

helps.

Best,

Kathy, mom to , 14.5 months in Starband 2.5 months

miriamsumner wrote:

I just got a reply from Dr. Menard:

Indeed your plan does not cover the $3000 helmet. You are free to

pursue the helmet at CIRS if you wish, but, with several publications

on the subject, 11 years of experience, and having seen thousands of

infants for this issue, I can tell you that the amount of change that

you will see if you choose to get the helmet will be minimal. Your

pediatrician can write you a prescription for the helmet if you wish,

and I have cc'd her on this message. Time and growth will help resolve

the 5mm of asymmetry that I measured yesterday, but the occipital

contour that you are concerned about may indeed be her genetically

determined head shape, and the helmet would do little to address that.

I'm not sure if he feels disrespected, that is why he listed his

qualification (publications, experience, etc.). By no means was I

trying to disrespect him, but as a first time mom, I worry about EVERY.

LITTLE. THING. I don't understand why it will help round out other

babies' heads but not mine! Is her situation not as bad as I see it? (I

emailed him back asking him to explain to me why it won't help, since

the band will force her skull to grow a certain direction.)

I'm definitely going to try and take some profile pictures this week

and post them up so you all can take a look.

> > > >

> > > > I would just call and ask them. They'll be able to

look at the plan you

> > > > have and tell you exactly what is covered. If

Kaiser does cover the band

> > > > they will only cover it if you go to CIRS. We have

a Hanger facility 5

> > > > minutes away from us so I called to see if they

would cover a Hanger band

> > > > and they would not. Someone else I know in town

flew down to L.A. for a

> > > > DOCband and they would not cover that either.

> > > >

> > > > Molly

> > > > Novato, California

> > > > Nicolas, 3.5, tort & plagio, STARband (CIRS

Oakland) 4/24/06-9/12/06,

> > > > Graduate!

> > > > , 6, 9.5

> > > >

> > > > Kaiser Insurance Coverage

> > > >

> > > > So I'm looking at the insurance coverage

information on kp.org, but I don't

> > > > understand the lingo. Can anyone help me figure out

if we will be covered

> > > > for the helmet if we need one?

> > > >

> > > > Here's what it says on kp.org:

> > > >

> > > > Durable Medical Equipment/Orthotics

> > > >

> > > > DME Basic Healthplan List - No Payment

> > > > DME Knox Keene Mandated Items - No Payment

> > > > Durable Medical Equipment Formulary - Not Covered

> > > > P & O Basic Healthplan List - No Payment

> > > > P & O Base Knox Keene Mandated Items - No Payment

> > > > Prosthetic and Orthotic Formulary - Not Covered

> > > >

> > > >

> > > > Do I just have to call and ask? Will it be a

STARband with CIRS? I can't

> > > > find a website for CIRS.

> > > >

> > > > Thanks.

> > > > Miriam

> > > >

> > > >

> > > >

> > > > ------------------------------------

> > > >

> > > > For more plagio info

[Guest guest]

Has anyone had any luck with Hanger in Nashua NH? i wanst to happy with them and plan on contacting Cranial tech in Conneicut on monday any experencie with them in Ct?

[Guest guest]

Hi Mirium,

I know Dr M told us that depending on which Kaiser plan you have coverage varies

widely, and he looks it up based on your plan. My employer selected one that

covered 100% so we were lucky.

Do you have any photos of the top of her head? I looked at the photos you took a

few months ago (I think you posted the link to Maysa's mom). She does look quite

flat in the photos. Dr M gave us the prescription for my daughter's brachy, and

I think his guideline is that banding should be done for 90% or higher. I know

you said she's 2cm bigger front to back, so I'm guessing her number must be well

below his cut off.

I would recommend going to CIRS for the scan and see what they say. Also I would

like to see more pictures if you can post some.

-christine

sydney, 3.5 yrs, starband grad

> > > > >

> > > > > I would just call and ask them. They'll be able to look at the plan

you

> > > > > have and tell you exactly what is covered. If Kaiser does cover the

band

> > > > > they will only cover it if you go to CIRS. We have a Hanger facility

5

> > > > > minutes away from us so I called to see if they would cover a Hanger

band

> > > > > and they would not. Someone else I know in town flew down to L.A. for

a

> > > > > DOCband and they would not cover that either.

> > > > >

> > > > > Molly

> > > > > Novato, California

> > > > > Nicolas, 3.5, tort & plagio, STARband (CIRS Oakland) 4/24/06-9/12/06,

> > > > > Graduate!

> > > > > , 6, 9.5

> > > > >

> > > > > Kaiser Insurance Coverage

> > > > >

> > > > > So I'm looking at the insurance coverage information on kp.org, but I

don't

> > > > > understand the lingo. Can anyone help me figure out if we will be

covered

> > > > > for the helmet if we need one?

> > > > >

> > > > > Here's what it says on kp.org:

> > > > >

> > > > > Durable Medical Equipment/Orthotics

> > > > >

> > > > > DME Basic Healthplan List - No Payment

> > > > > DME Knox Keene Mandated Items - No Payment

> > > > > Durable Medical Equipment Formulary - Not Covered

> > > > > P & O Basic Healthplan List - No Payment

> > > > > P & O Base Knox Keene Mandated Items - No Payment

> > > > > Prosthetic and Orthotic Formulary - Not Covered

> > > > >

> > > > >

> > > > > Do I just have to call and ask? Will it be a STARband with CIRS? I

can't

> > > > > find a website for CIRS.

> > > > >

> > > > > Thanks.

> > > > > Miriam

> > > > >

> > > > >

> > > > >

> > > > > ------------------------------------

> > > > >

> > > > > For more plagio info