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View Full Version : Spinecor appt. and insurance



Izzy's Mom
09-16-2008, 02:33 PM
Hi everyone,

Well we have our appointment scheduled. We go to see Dr. Rivard on Sept. 30. We've been looking at our insurance (bluecross/blue shield) and we're not sure if the brace or the out of country hopspital visit will be covered. I"ve seen something about an L code. I can't seem to find the thread about it. Does anyone have any experience, suggestions, or advice about this?
Also, if anyone has any suggestions about the first visit ( questions to ask, how to prepare ourselves and our daughter), I'd love to hear from you.
By the way, we our not flying this first time. We won't be able to get our passports in time. We decided to break up the trip by stopping at grandma and grandpa's house. It will be good for the whole family to see each other. We all need every ounce of support that we can get right now.
Thanks again for all of your support and advice. I can't say it enough, how helpful this has been for me.
Theresa

Mom37
09-17-2008, 12:44 AM
I wish you the very best outcome possible. I suggest taking pictures of the brace on, in front, and back. If needed take notes on where the straps go if the doctor doesn't give you a step by step. Actually we did get a brochure but still would have helped. We went out of state, and were worried about forgetting how the straps went. We were given booklets and pictures, but each individual can be different depending on the curve. My daughter liked the spinecor bodysuit and we did get one extra, but wish we had more then. Some kids don't like the bodysuits, so you may just find out how to get more if you decide to later. Also my daughter had to go the next day to get a pad that kept the strap from rubbing her underarm with the strap under it for her. She had right thorasic european if I remember correctly. It was 2 years ago. My insurance paid out of network cost, but I did have to pay out of pocket first and then be reimbured. I have good insurance with my company self funding the insurance, but underwritten by United Healthcare. We didn't go out of country because I didn't know if they would pay and was trying to do as quickly as possible. My daughter had other medical conditions we found out about later so her curve couldn't be held by any brace, but we did what we needed to at that time. We though Spinecor was the best bracing option for my daughter.

christine2
09-17-2008, 04:14 PM
We also have Blue cross. They covered out of network for the brace, OV and x ray. We also have a durable medical deductible. Our ins. has not given us any problems to date. But if there is a problem I would FIGHT!! I also think because you are seeing an ortho vs a chiro coverage will be easier.

The first visit is like a whirlwind. This is how it happened for us. A very nice nurse met us at the reception area and brought us down to the bracing clinic. It is in the basement of the hospital. Dr Colliard does a bunch of measurements,They then sent us up for out of brace x rays. The hospital has a very cool machine I think it is called a Q scan. I was told it cuts down radiation exposure by 90%. (A GOOD THING) Then you go back down to the clinic and Dr Colliard puts on the brace. Then you go back up for in brace x rays. Dr Rivard then pulls up the x ray and tells you the correction. You can ask him anything. He will be completly honest with you. It is very important to him that the brace is successful so he does not give any false hopes!!

Keep in mind that the hospital is not like hospitals in the states, it is not fancy!! St Justines is the top research hospital in Canada so they are on the cutting edge of technology.

I actually took pictures too. I also wrote the corresponding #'s with a permenent maker on the base. This helps at school and daycare if a snap comes off.

Another thing i did was set up playdates with my daughters freinds outside of school so she could show them her brace. I showed the kids the x rays and explained the reason for the brace. I really believe that that helped my daughter to accept it and not worry about hiding it. In fact last year during Scoliosis week she got up in front of the class and explained her curve and showed the x rays.

Theresa I know I said that I don't post here anymore but I can't help myself, I must share my experiences!! It is my responsibility to share.

Jenmom
09-18-2008, 01:56 AM
Hi Theresa,

Well I know exactly how happy you must be to have the appointment but nervous at the same time. We have bluecross and it was covered with the L code, I can try and find it or even call our ortho and get it if you need me to. The brace and all appt. are covered for us. They said the insurance will cover a new brace after a year if it is worn from washing. I wanted to video tape the fitting but my daughter didn't want me to. So between my husband, daughter and I we had to remember everything, and asked a lot of questions. The first night, actually the first couple of days were pretty tough. The brace is tight and it takes a few days to get used to. Jen felt she couldn't breath and I called our ortho to ask if that was normal. He said yes it is very tight but that she would adjust and she did. He also said most kids have a melt down the first day so at least you can know it is normal if she does. You will need to wash the bottom part in a garmet bag so the #'s don't come off and to protect it so getting one would be good. I got Jen enough bodysuits that I wouldn't have to wash them every night. God bless you both.

Kathy

jillw
09-18-2008, 02:49 PM
Kathy brings up a good point about the meltdown! My daughter was very uncomfortable in the car trip home, but a big sundae from friendly's while watching a DVD in the car did help distract her. However, that night after she took her bath and we were trying to put the brace back on, she freaked! Not that she resisted having the brace put on, she was compliant, but that she said it hurt. Part of it I think was that she picked up on my husband and my anxiety (not confident that were we putting the brace on correctly - husband said strap goes one way, I said, no another way) Of course her reaction to the hurting was so strong I was afraid it was on wrong (it wasn't). It was a tough first few nights but it got much better.

Izzy's Mom
09-19-2008, 01:55 PM
Hi everyone,

Sorry that it's been a couple of days since my last post but it's been crazy here. We've had gymnastics, softball, open house at school, CCD classes starting, and the list goes on. Just because I haven't posted doesn't mean that you all haven't been in my thoughts and prayers.
Thanks everyone for all of the great advice. Everything you have said has been so helpful. We are trying to get everything in order with our insurance and looking into the "L code". Right now that's the least of my worries. I'm spending alot of time preparing for the visit with Dr. Rivard. I'm compiling list of questions for him and getting my camera and my sharpie ready. We've also spent our time talking to Isabella about the trip so she knows what to expect. We've even shown her pictures of Dr. Rivard and the hospital, that we found on the net. I'm glad that you warned me about a possible meltdown. At least I'll know to have a little something extra planned in case this happens.
So far, Isabella has been very good. She's excited about going to Montreal. She is thrilled that she is getting the Spinecor and not the hard brace.( I am too!) I also think that she has been dealing with this very well because her cool Aunt V. ( my husband's 23yr. sister who she absolutley loves) also has scoliosis. It's been great that Isabella has her to talk to.
This week we've also had a meeting with Izzy's teacher and the school nurse. Everything went well and they are more than willing to make any accomodatiions that are necessary. Both were very kind and understanding of our situation. The nurse was very interested ine the brace. She has at least 1 or 2 students a year who are in a brace, but has never seen or heard of Spinecor.(Hopellfully we will have good results with it and the word will spread)
I also wanted to talk about Isabella and her future brace. Sometimes she wants to tell people about her brace and other times she does not want to let people know she is getting a brace. I know when she's ready to tell people about it she will, but at the same time I don't want her to feel embarassed. One way that I have explained it to her is that people get a cast when they break their arms and they don't try to hide it. Instead of a cast you need a brace to help straighten out your back. This has helped her to put things in perspective.
Thanks again for all of your support!!!!!!
Theresa

jillw
09-24-2008, 05:14 PM
Hi, in case you are still looking for the "L" code, it is L1005

Izzy's Mom
09-25-2008, 09:11 AM
Thanks for the info on te Lcode. We definitely have to look into it because we are on our own now. Unfortunately, our ortho here said he would write a prescription for the spinecor ( which is useless since we already have our appointment), but he will not write a letter of medical necessity or a letter to our insurance co. justifying the use of it.

Theresa