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We decided on Schroth and spinecor

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  • #16
    Originally posted by MitoMom View Post
    Here is one of the many lessons I've learned with John on our 20 year journey through the medical and insurance world: It is easier to deny a claim than to pay it.

    Before going through the appeal process make sure that the right billing codes are being used to describe the brace and treatment plan. A lot of time those codes are what cause the claim to be kicked out by the computer. But when the claim is reviewed by a person they get approved.

    It might also help to get a letter from your orthoped explaining the rational for the brace as well as the therapy. It should also include a statement by the dr that this is less invasive than immediately taking your child into surgery at $$$,$$$ with the potential for even more $$$,$$$ due to needing a revision because she had the surgery so early. Drs write these kinds of letters all the time so don't hesitate to ask for one. They also know the cue words that get the insurance to pay attention.

    Check your policy, document who you spoke with, date & time, ask for their supervisor and keep going up the chain of command and through the appeals process. You may be pleasantly surprised.
    That is excellent advice.

    For example, vertebral body stapling (VBS) surgery has been covered by several insurance carriers over the past few years, but ONLY after the patient, along with the doctor involved, filed an appeal. In the case of VBS, most insurance carriers will deny the claim initially (because they can) - but many have reversed their decisions once an appeal was filed.
    mariaf305@yahoo.com
    Mom to David, age 17, braced June 2000 to March 2004
    Vertebral Body Stapling 3/10/04 for 40 degree curve (currently mid 20's)

    https://www.facebook.com/groups/ScoliosisTethering/

    http://pediatricspinefoundation.org/

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    • #17
      BigBlueFrog........Your insurance may not cover "Schroth", persay.....But, IF the Schroth practitioner (or one of them there) is a licensed physical therapist, your insurance may cover it.

      My insurance will cover physical therapy, so if my doc prescribes physical therapy and my Schroth practitioner is a licensed physical therapist, (which she is), my insurance will cover the sessions.....Check out if your insurance will cover PT....

      I have made some decisions also.....we are going with Schroth, Iyengar yoga classes, torso rotation machine at the gym, and if a brace is needed, a Rego Cheneau........

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      • #18
        Thank you for wishing us well...we leave tomorrow for Steven's point.

        I have fought the insurance issue to the highest level. We carry an HMO with only in network providers...since schroth uses the same PT codes it has been denied because the PT in network have the same codes. I wrote letters and the doctor called and went back to back for me the highest level for considering coverage...all denied. I believe its because there are no studies in the US of successful treatment. The clinic we are going to ...gave me a reference sheet of 3 pages of happy patients from all over the states. About 50 names. I have read the Katrina Schroth book...fascinating. The videos online show quite impressive improvement with patients.

        So we will pay out of pocket..its only money, this is our child..and I guess for me I need to know that we tried our best to help her.

        Her curves are 25 -27 degrees...depending on who reads them. I often wondered what would happen if we did nothing....or if we try everything...what will be... will be.
        age 15
        Daughter diagnosed at age 13
        T20 l23 10-09
        T27 L27 1/2010

        T10 L 20 in brace 4/2010
        T22 L25 12/2010 out of brace
        T24 L25 7/2011 out of brace

        Type 1 diabetes- pumping
        Wearing a Boston brace and Schroth therapy
        Faith, Hope, and Love- the greatest of these is Love

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        • #19
          BAck from Schroth therapy

          okay we only finished a week of therapy, and already she is taller ....lol that may be genetics.

          They measured her on the first day and took pictures...after 5 days she was a 1/2 inch taller.

          the exercises were to lengthen her spine and use the smaller muscles that are attached to the spine to recondition them to help strengthen and straighten the back. They use a special breathing technique called rotational breathing, to help expand areas that have collapsed from the spine twisting.

          We been doing the exercises at home twice a day, since she still has no brace.

          We will get rolfing this week too.
          age 15
          Daughter diagnosed at age 13
          T20 l23 10-09
          T27 L27 1/2010

          T10 L 20 in brace 4/2010
          T22 L25 12/2010 out of brace
          T24 L25 7/2011 out of brace

          Type 1 diabetes- pumping
          Wearing a Boston brace and Schroth therapy
          Faith, Hope, and Love- the greatest of these is Love

          Comment


          • #20
            We have also considered going to WI for Schroth. It is my understanding there are a couple different places in WI. I have been talking with Scoliosis Rehab.

            The past week or so I have been reading the Three-Dimensional Treatment For Scoliosis book (the original Schroth book). It is very helpful. There are some very basic concepts in it that a person could do right now. However, some of it is much more complicated and I can see the value in having a trained therapists. The book may be helpful for anyone going to the therapy to get a basic understanding of the method. The book provides a lot of detail.

            As my daughter has recently completed the Clear Method intensive treatment and as she does about two hours of therapy/exercises daily, the basic concepts are very similar to Schroth:

            1. Elongate the Spine
            2. Work on Derotation of the Trunk
            3. Strengthen and Stretch Muscles

            We have been able to incorporate some very basic Schroth methods into her exercises (very basic ones!). I just wanted to mention that I have read the book and it has been very helpful. If nothing else I have a much better understanding of how the spine and the muscles need to work together. I wish I would have read it before our Clear Method treatment, some of the treatment would have made much more sense to me.

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