spinecor

[rtremb]

Hi Everyone:
For Ontario residents - attached is my letter to Spinecor asking they submit information on the Spinecor brace for consideration for inclusion in the Ontario Assistive Devices Program. Hope they do this and the brace gets approved.
Ruth

[2kids]

Hi Ruth,
Thanks for sharing the letter to SpineCorporation with us. I sure hope they send the necessary documentation to OHIP for approval. Does anyone know if this brace is covered by insurance in the USA? I have tried to read the fine print on our plan, but it looks like only hard braces (DME) are covered. It sounds like the company needs to advertise their research findings more with doctors. I asked my DD's orthopedist about it at the appointment last week, but I do not think he is familiar with this type of brace.

How much does a SpineCor brace run in Canada? I notice you go to Montreal for the appointments because you are in Ottawa. My parents are in Toronto, so I wonder if it would be worth looking into this with a doctor there.

At the suggestion of folks on this forum, I contacted the Baltimore doctor offering this option. The office manager knew nothing about it and was told to email the doctor directly. I hope I hear from him soon. I haven't a clue what this brace would cost. I heard a hard plastic brace is $4200.

Thanks!

[rtremb]

2Kids:

We paid $3,160.00 Canadian for the Spinecor brace in Montreal. This included an extra bodysuit at $60.00 which my daughter won't wear!! She wears a long thin vest with sleeves (made in Italy) and panties with it.
We don't have to pay for the x-rays or the consults with the doctors in Montreal because this is covered by a reciprocal agreement between Ontario (OHIP) and Quebec (QHIP).

Ontario Assistive Devices isn't part of OHIP it is an independent Ontario government program.

I don't think the Spinecor is available in Toronto because when we went to get Esme's brace there was a Mum there with her son who said she wasn't able to get it in Toronto and she had to travel to Montreal to get it.

Ruth

[stephanieC]

Hi 2kids,

My insurance company, Blue Cross/Blue Shield, was going to cover the spine cor brace. I am not sure how much the reimbursement would have been as I have chosen not to go with bracing but rather to do the Vertebral stapling procedure. It was not an easy decision. The only brace I would consider was the spine cor and we travelled far down the path before choosing the Stapling option. I found a few doctors who use the spine cor brace here in the USA. I had contacted my insurance company with diagnosis and codes and what not and was told there would be reimbursement.

Spine cor has come a long way in the past couple of years here in the US. I even found an ortho doc who is not a scoliosis specialist who uses the spine cor brace. She is out on Long Island, NY.

Dr Sponsellor(spelling??) In Maryland does have experience with this brace. He will contact you back. Dr Sanders, at Shriners in Erie, Pennsylvania also uses this brace.

I chose vertebral stapling because the results to date are very good and it offers young children the option of not wearing a brace for so many years of their young life. Michela is 9, she would be looking at 7 years of bracing. Not a great option for her. I researched a long time and spoke with Dr Rivard in Montreal personally, a very compassionate doctor. I had a consult with Dr. Boachie in NY, and Dr Haralabatos out on Long Island, NY. Then I met with Dr Asghar at Shriners Hospital in Philadelphia. Another kind and compassionate doctor. My husband and I, with input from my daugher, decided on the VBS.

Many doctors don't know about or trust spine cor yet. But many do. Visit the spinecorporation.com for a list of US doctors and orthotists who work with spine cor.

I wish you good luck as you research your options for your child!!

Stephanie

[jillw]

Stephanie, Would you mind telling me what the applicable codes are? I haven't submitted anything for insurance yet because I haven't gotten the codes yet (although the receipt for the brace is hand written and not what I'm used to seeing in the US; not sure how credible U.S. insurance companies will think it is)- but we use blue cross/blue shield also. Thanks!

Jill

[stephanieC]

Hi Jill,

I am sorry to say that I haven't saved that information. However, I do remember where I got it. Dr Deutchman is a chiro in NYC. He runs a spine center that uses spine cor exclusively. His office manager, a man whose name escapes me, is very nice and forth coming with information. He gave me all the info regarding how to collect from my insurance company because I don't think that office takes any insurance. I would of had to submit on my own. I do not still have there contact information. However, I know there are people on this forum who see Dr Deutchman.

The other office that I spoke with regarding insurance was an orthotists office out on Long Island, NY. This orthotist (who would have fit the spine cor brace for the pediatric ortho I was seeing out in Stony Brook)was Steve Mullins @ Mandelbaum Orthotics in Port Jefferson, NY. Phone number 631-473-8668. The woman that I spoke with was very helpful. I do remember contacting my insurance company to see if I needed to get a pre authorization for the brace. BC/BS said yes, a pre auth. is needed. The woman in this office that I spoke to said they had received payment before for the spine cor brace. The woman at BC/BS said yes they reimburse on spine cor. First get the prescription, then the pre authorization, then go ahead and have the brace fitted and submit for payment.

You may have less of a reimbursement for not getting the brace pre authorized, but I believe you will still get something. Out of network reimbursement maybe??? It's definitely worth a try.

I hope this was helpful.

Best,
Stephanie

[WNCmom]

Jill--

We have Assurant Health insurance, which covered all but $600 of a $3800 SpineCor brace. The code was L1005. The insurance company processed it as in-network because there are so (relatively) few docs who fit it, and none near me--and this was a chiropractor in Atlanta. I just submitted the bill to the insurance company myself, although Dr. Ouellette said he would help with a letter if I needed to appeal.

So yes, some companies in the U.S. do cover it.

Mary Ellen

[gallathea]

Hi Jill:

I have Harvard Pilgrim Insurance. I had to first submit a claim, get it denied, and then appeal. I think I may have been the first to ask for coverage of the Spinecor because they didn;t have a code for it. After submitting Dr. Rivard's letter as well as our own arguments, they agreed to cover it as an out-of-network expense--80%. Initially they had turned me down because my plan doesn't cover anything out-of-country. I don;t know if they would have continued to pay for future braces. They said this was a one-time only payment.

Best,
Caroline

[WNCmom]

6 week Spinecor check-up; new brace shorts

Just want to report on Sidney's first check-up on his Spinecor brace, after 6 weeks of wearing it. There was no change in the curve (which had initially been reduced 7 degrees thoracic and about 4 degrees lumbar)--it's still T41 L31 in-brace. While we were relieved to know it had not increased, we also knew he had not grown any since he got the brace. Also, we like the brace so much (relative to the Boston, that is!) we had hoped (unrealistically, I'm sure) there would be some slight reduction.... The doc didn't expect any further reduction at this point, and told us the checkup was just to adjust the brace if necessary and make sure all was going well.

Also, Spinecor now makes a new brace part that replaces the plastic pelvic band and does away with the snaps. It's a pair of mesh shorts with velcro that can be snugged at the hips and to which the velcro tabs on the straps can be attached. We'd been having some trouble with the snaps coming undone, and were given the option of getting the shorts (we had to pay), so we went for it. Sidney seems to like it better; there is a small front velcro flap that comes undone which makes going to the bathroom easier if you're a boy. Also, it's relatively easy to pull down the shorts without having to undo the whole brace. In general, we think it's an improvement. If anything, it seems to be holding the straps more tightly than before.

Knowing that my husband's family has "tall genes" and that Sidney has always been long and tall for his age, we are aware that he has much growing left to do. At age 12, he is 5'4". I have to say I am feeling discouraged right now, wondering whether he will ever be able to make it through the growth spurts to come without the curve increasing dramatically. It definitely feels like a low spot, because most of the time we are able to be at least somewhat optomistic. Our next appointment is in 3 months.

Mary Ellen

[rtremb]

Hi Mary Ellen:

Glad to hear there has been no increase in curves although it must be somewhat disappointing there has been no decrease. We go back to Montreal this Wednesday and I am very worried what we will be told - Esme's curves have a habit of jumping up suddenly. I am hopeful the Structural Integration (Rolfing) will have been helping as well as the Spinecor.

Are you doing the Rolfing 10-series? Is there a system to what you are having done?

Ruth

[WNCmom]

Hi Ruth--

I have been very interested to hear how Esme's SI sessions have been going, and I can tell you are really encouraged.

At this point we are just doing the MFR, because we really like and have faith in this practitioner, and we live in a very rural area--I don't know if there are any Rolfers close by. We may eventually go to SI, but for now we are doing this. The doc did ask us last Wednesday at the brace checkup if Sidney was wearing a shoe lift, because his elevated hip is now just slightly lower than in the x-ray taken 6 weeks ago. He has not been wearing a shoe lift; I'm hoping it's the MFR beginning to show an effect--he's had 4 sessions so far, with another scheduled for next week.

Also, Scoliosis Rehab in WI provided me with a list of names of parents who had taken their children there, and I'm about to start gathering info on that... That's where I am. I think I'll ask the massage therapist on Wednesday her opinion on Rolfing and scoliosis. I do think she has a plan, but I feel sure it's not like Rolfing.

Thanks for posting those links on the other thread. I really appreciate all the research you are sharing. Good luck on Wednesday, and please let us know how it goes.

Mary Ellen

[Allegra]

soinecor shorts?

Mary Ellen,
If you get a chance, would you mind posting a picture of these new shorts?
I'd really love to see them, as the whole pelvic belt part on my brace keeps sliding up, making it extrememly uncomfortable.

For the update, I still haven't gone back to the brace people/surgeon I saw in August and September, so I really hope it's working.
I know my spine is a lot straighter after a night of wearing it, so I'm assuming all the time in it is helping.

Has anyone heard from Gerbo lately ??

[WNCmom]

Allegra--

I'll try on the picture. I can handle a digital camera okay, but attaching a photo to a post may take some time for me! Hope you can be patient. By the way, the shorts seem to be working well for Sidney. He did complain about a "wedgie" feeling early on one day, but no compaints since! He wears underwear under the shorts, as recommended.

Mary Ellen

[Celia]

Has anyone heard from Gerbo lately ??

Yes! Last time I checked he was in the Juvenile section defending me from an angry mob (thanks Gerbo, you're a sweetie!!!) and after that he was getting into a heated discussion with Structural75 over semantics. I think he's entitled to a day off

[Allegra]

Mary Ellen,
Take your time, there's no rush. I'mjust interested to see what i could be trying. I think I need to make a list of all my questions for our spinecor person. I'm pretty sure he put the bolero the wrong way when fitting me! Grrrr ahahaha
I think I'll start a new thread to talk about that.....

Celia,
Oh no...another debate with structural??
oh myyy....