Time for New Orthotics

Posted on August 30th, 2013 by Denise | No Comments

Time for New Orthotics

By

Denise Koonce OTR

School has started and the fall schedule is beginning.  The family calendar becomes a blur of markings, being fully utilized over the next few months with school responsibilities, after school activities, holidays, teeth cleanings, doctor’s appointments and various other commitments.  However, for families who have a child with special needs, scheduling certain medical appointments, such as physical medicine and rehab, gastroenterology, neurology, and orthopedics in advance, is even more critical.  Another area that requires advanced planning is for the procurement of medical equipment such as wheelchairs/durable medical equipment and orthotics.  One of the reasons for the advanced planning is due to the uneven ratio of specialized health care providers for the pediatric special needs population.  Virtually there is a greater need for services than there are service providers, creating a very busy schedule for these offices.  Also, the upcoming year-end means a new insurance year will begin, restarting the deductible and co-insurance amounts.  So if you know there is a need for medical procedures, evaluations or equipment do not wait until December to start scheduling.  Therefore, it is helpful to try to plan ahead as much as possible for the needs of your child from these providers. 

I recently was required to make an orthotics appointment for my daughter, not because it was planned but because there was an oops!  My daughter and her father had the opportunity to go fishing recently.  They got all of their gear ready the day before, had new lines strung, obtained yummy snacks, and set their alarms for early.  Unfortunately, the next morning when my daughter was putting on her hunting/fishing boots we realized they were too small.  So she instead put on her tennis shoes and off they went.  Fishing, or rather catching, wasn’t going so great on the jetty so they decided to try fishing from the beach.  When they returned home and we realized that her shoes had gotten wet, I remembered the orthotics.  Sure enough all of those wonderfully formed layers that had been molded together were now separated!  Time to make an orthotics appointment!

Our orthotics visit was unexpected, much like what happens when our children go through a large growth spurt, but otherwise a majority of orthotic appointments are expected and made primarily during the summer and before the end of the year.  Many families try to make their orthotic and brace appointments during the early summer months so there is ample time for an evaluation, casting, delivery and fitting, and then secondary fitting, if necessary, before school starts therefore minimizing missed school time.  It is best to try to make your initial appointment in June after receiving a prescription from their physician, in order to allow enough time to complete the whole process prior to school starting. 

The other common time for families to try to schedule appointments for new orthotics or brace fittings is prior to the end of the year.  This time period is a little trickier because it coincides with the holidays and the end of your health insurance year.  If your child is going to need orthotics prior to the end of the year, here are some tips which might make your experience smoother.  Again it is important to plan ahead, which includes obtaining a prescription.  Knowing that it can be difficult to coordinate a pediatrician, orthopedist, or physical medicine and rehab physician appointment on the spur of the moment, realize an orthotic and brace prescription will be effective for 6 months from the day of issuance.  So, if you are seeing the physician during the summer and know that orthotics will be needed prior to the end of the year, request a prescription at that time.  It is also recommended that you go ahead and mail or fax the order to your orthotist’s office so they can keep it on file in your child’s record.  This is helpful in the event the original prescription becomes misplaced.  It is best to make an appointment no later than late October or early November for an evaluation and casting for new braces or orthotics.  The reason for this timing is to allow for the complete process to occur.  For example, once the casting is complete it takes the company at least 3 weeks to receive the completed product.  Once the product is received a fitting appointment is scheduled and then and only then can the insurance be billed.  So if you are trying to procure a pair of new orthotics prior to the end of the insurance billing year, you will need to be at the fitting stage no later than early December in order for the company to be able to submit the charges in that year. 

All of these medical appointments are necessary but they do not have to be frustrating or stress producing if you plan ahead and understand some of the systems involved.  If you have other helpful hints regarding the above, please share them with us.

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