Our dedicated insurance team at Cranial Technologies will be with you every step of the way. We strive to take the stress and hassle out of the insurance process, so you have more time for your little one!
It's our responsibility to help reshape your baby's life with options that don't strain your finances. While we strive to obtain the best potential coverage from your insurance plan, you may still have co-pays, deductibles, or other out-of-pocket costs for treatment.
Let us handle the hassle of securing your medical documents and coordinating with your doctor for a seamless experience.
We'll connect with your insurance provider to verify your coverage and understand the requirements of your insurance plan.
Our team will explain your insurance benefits and provide clear estimates on treatment costs so you can make an informed decision.
Our goal is to ensure a seamless experience for our patients. This includes minimizing the administrative burden so you can focus on what matters most.
You're a new parent, and new parents are incredibly busy. So we've made it easy to find time for treatment that works with your schedule.
Our team has you covered from consultation to graduation!
We understand you may be eager to start treatment. There are cases where babies can begin treatment without waiting. Our dedicated team will go over all available options with you.
Once we send all the required documentation to the insurance company, it typically takes around 7-10 business days to perform the insurance review. This varies based on insurance carrier. Once completed, we will contact you to review available benefits.
If your insurance plan requires you to wait for the results of the pre-treatment insurance review prior to starting treatment, our insurance team will reach out to you. They will provide you with the necessary information and estimated cost to help you schedule your baby's treatment. Please note that scheduling prior to completing this step may not be possible.
Our insurance team will contact your insurance provider to determine what benefits are available. They will then contact you to go over that information. Coverage depends on each individual policy and each individual child. About 70% of all insurance providers have some type of coverage for the band. Some providers require that we get services approved prior to starting treatment. We will obtain any authorizations that might be required.
While we recognize the importance of acting quickly once you have decided to treat your baby, we are limited by the processes many insurance companies follow, which sometimes take 2-4 weeks. You can be assured that we will do everything we can to try to speed this along, but please recognize that we do not control this part of the process.
S1040-Cranial Remolding Orthosis is the one and only procedure code for the DOC Band (for Plagiocephaly and Craniosynostosis).
Q67.3-Plagiocephaly is the most used diagnosis code. It encompasses babies with both plagiocephaly and brachycephaly diagnosis.
Q75.0 would only be used post-operatively following surgical correction of Craniosynostosis.
Could be any of the following depending on your specific insurance plan:
Due to individual insurance contracted rates and your specific policy benefits, we will be able to give a better quote of your estimated cost share once our Insurance team have verified your benefits after the free evaluation.
Prior authorization is a pre-service review that is required by your insurance policy. Insurance typically reviews for either medical necessity, benefit coverage, or both. If authorization is not submitted prior to treatment, your insurance plan can penalize or deny paying for treatment solely on this basis. Additionally, many cases require waiting for a final determination before beginning treatment.
A pre-determination is a voluntary pre-service review. Your insurance plan will not penalize you for not submitting the review, but it is offered to you due to the specific nature of the DOC Band treatment. Like a prior authorization, the review is for medical necessity, benefit coverage, or both.
Neither prior authorization or a pre-determination is a guarantee of payment from an insurance provider, even when approved.