During our free consultation, one of our specially trained clinicians will determine if DOC Band treatment is recommended for your baby. If treatment is recommended, our dedicated insurance team will receive your baby’s chart and begin navigating the insurance process to provide you an estimated cost for the DOC Band prior to starting the treatment.
Determining Insurance Coverage
Cranial Technologies is contracted with many commercial and state insurance providers. Even if we are not contracted with your insurance provider, some coverage may still be available. Potential In-Network or Out-of-Network coverage varies depending on each patient’s specific insurance policy benefits and your insurance provider’s individual criteria for medical necessity. Our insurance verifications team will contact your insurance provider to determine network status, anticipated coverage, and if prior authorization is required or offered for your specific policy. We will also work with your baby’s healthcare provider to obtain a prescription for DOC Band treatment and any other necessary documentation specifically required by your insurance plan. Once the general benefit information has been obtained, one of our Insurance Liaisons will reach out to you to review the details and next steps in the process.
In many cases, a pre-service review must be initiated prior to beginning DOC Band treatment. These reviews can either be required or voluntary depending on the specific rules of your policy. Most cases that require a pre-service review do not allow for DOC Band treatment to begin before a response has been received from your insurance provider. The pre-service review process typically takes 7-10 business days once we have submitted all necessary documents to the insurance company. If you are required by your insurance plan to wait on the outcome of the pre-service review, you will be contacted by our insurance team once the outcome has been received.