Re: Success Rate/Insurance Coverage

November 13, 2008

You didn’t mention how old your child is.

Our foster son had torticollis since birth (in-utero).

He was not a multiple birth and I didn’t know anything about the pregnancy.

But, I did notice that after a month, his head was not rounding out as you’d expect after a vag. delivery w/ slight misshapen head.

1st he got occupational therapy. With this they ‘claim’ that once the child has the full range of motion to their neck, the head might start rounding out on it’s own. At first, we did see some improvement to his head. Then, it plateau’d – his head didn’t keep rounding out.

Starting at about 4 mos. he also saw a cranial-facial plastic surgeon and followed up with him every 6 weeks. After 3 mo. of monitoring with the cranial-facial dr., they referred us to Cranial Technologies for a DOC Band. He has ‘severe plagiocephaly’ from the torticollis. Less than a month later, head was fitted for his band – at 8 mos. old.

He has been in his band for 1 month and the doctor has stated that the results have been better than expected (especially for his age when he started).

We have been VERY happy with the band.

I wonder where the PT’s stats are coming from. Are they from the old helmets? And at what ages? That would make a HUGE difference.

My SIL is a PT and president of the PT Association of Central Texas. She suggested we get him a band as well when she visited. She didn’t realize that we were doing the necessary steps toward that already. No offense to your PT, but it sounds like you might have to by-pass her to get what you need.

Cranial Tech DID tell me before we got the band that we HAD done what we need to help ensure it would be covered. So, I recommend getting your Pedi to refer you to a cranial-facial plastic surgeon if you have not gone already. Then get them to refer you for a band. Even IF your insurance doesn’t require a referral, having it charted by these other doctors will definitely help when you go to appeal it (and if you are denied coverage, definitely appeal it – or ask if the office can appeal for you, but it never hurts for you to be the one doing the appeal.)

Your child will never have a ‘perfect’ head. But, no one does. That is what gives each of us character!

And, remember, time IS of the essence and no one will advocate for your child better than you, be aggressive!

Good luck!

Margaret

(new to the group)

Success Rate/Insurance Coverage

Posted by: " kboney29 " kboney29@... kboney29

Wed Nov 12, 2008 4:03 pm (PST)

Hello everyone, I would appreciate some info.

My daughter has torticollis that has caused flattening on her right

side. I have been told by her physical therapist that the helmets are

still kind of controversial because they only have about a 50% success

rate. Is there any truth to that? I figure that not all children end

up with a 'perfect' head, but I would expect some correction with the

helmet.

I was also wondering how many of you were about to get insurance to pay

for the helmet? And if so, what degree was the flattening?

Thanks!!

November 13, 2008

Thank you much!

My daughter is only 3 months old, but I am trying to educate myself

before going into things. I noticed that she was tilted and turned

one way a couple weeks after birth. They believe she has tort

because she was dropped very low my last month of pregnancy, aka

cramped. Her tort seems to be getting a bit better, but I am

concerned about the flattening on one side. She is already 7 mm

off. I wonder also, at what point should you band? 10mm? Or more?

It is tough because there are no definitive answers because it is

technically cosmetic and some people wouldn't care about flattening

at all. But I want to give my daughter everything that she deserves

and that includes the most 'normal' appearance as I can provide.

Thanks again for the info.

>

> You didn't mention how old your child is.

> Our foster son had torticollis since birth (in-utero).

> He was not a multiple birth and I didn't know anything about

> the pregnancy.

> But, I did notice that after a month, his head was not

> rounding out as you'd expect after a vag. delivery w/ slight

> misshapen head.

>

> 1st he got occupational therapy. With this they 'claim'

> that once the child has the full range of motion to their

> neck, the head might start rounding out on it's own. At

> first, we did see some improvement to his head. Then, it

> plateau'd - his head didn't keep rounding out.

> Starting at about 4 mos. he also saw a cranial-facial

> plastic surgeon and followed up with him every 6 weeks.

> After 3 mo. of monitoring with the cranial-facial dr., they

> referred us to Cranial Technologies for a DOC Band. He has

> 'severe plagiocephaly' from the torticollis. Less than a

> month later, head was fitted for his band - at 8 mos. old.

> He has been in his band for 1 month and the doctor has

> stated that the results have been better than expected

> (especially for his age when he started).

>

> We have been VERY happy with the band.

>

> I wonder where the PT's stats are coming from. Are they

> from the old helmets? And at what ages? That would make a

> HUGE difference.

> My SIL is a PT and president of the PT Association of

> Central Texas. She suggested we get him a band as well when

> she visited. She didn't realize that we were doing the

> necessary steps toward that already. No offense to your PT,

> but it sounds like you might have to by-pass her to get what

> you need.

>

> Cranial Tech DID tell me before we got the band that we HAD

> done what we need to help ensure it would be covered. So, I

> recommend getting your Pedi to refer you to a cranial-facial

> plastic surgeon if you have not gone already. Then get them

> to refer you for a band. Even IF your insurance doesn't

> require a referral, having it charted by these other doctors

> will definitely help when you go to appeal it (and if you

> are denied coverage, definitely appeal it - or ask if the

> office can appeal for you, but it never hurts for you to be

> the one doing the appeal.)

>

> Your child will never have a 'perfect' head. But, no one

> does. That is what gives each of us character!

>

> And, remember, time IS of the essence and no one will

> advocate for your child better than you, be aggressive!

>

> Good luck!

> Margaret

> (new to the group)

>

> Success Rate/Insurance Coverage

> <Plagiocephaly/message/170130;

> _ylc=X3oDMTJyZGw1dm1xBF9TAzk3MzU5NzE1BGdycElkAzQwNzI4MQRncnB

> zcElkAzE3MDUxMjYxNzEEbXNnSWQDMTcwMTMwBHNlYwNkbXNnBHNsawN2bXN

> nBHN0aW1lAzEyMjY1ODIxNzk->

> Posted by: " kboney29 " kboney29@...

> <mailto:kboney29@...?Subject=%20Re%3ASuccess%20Rate%2F

> Insurance%20Coverage> kboney29

> <kboney29>

> Wed Nov 12, 2008 4:03 pm (PST)

> Hello everyone, I would appreciate some

> info.

> My daughter has torticollis that has caused

> flattening on her right

> side. I have been told by her physical

> therapist that the helmets are

> still kind of controversial because they

> only have about a 50% success

> rate. Is there any truth to that? I figure

> that not all children end

> up with a 'perfect' head, but I would expect

> some correction with the

> helmet.

> I was also wondering how many of you were

> about to get insurance to pay

> for the helmet? And if so, what degree was

> the flattening?

> Thanks!!

>

November 14, 2008

Unfortunately, it may not be so much a matter of how off your child is before you band as to WHEN you can get it cleared through your insurance. I’d be working toward that now.

As far as it being considered ‘technically cosmetic’ that is bull in my opinion. Even our PT from Cranial Technologies said that wasn’t true. Our son’s eye on one side was slightly more forward that the other. SO, there are future potential eye issues, jaw and teeth issues, ear issues, etc. Don’t let anyone tell you otherwise!

Re: Success Rate/Insurance Coverage

Posted by: " kboney29 " kboney29@... kboney29

Thu Nov 13, 2008 5:41 pm (PST)