Why does my child need to be casted?
All custom orthoses require a casting appointment where we will first conduct a full assessment of your child before taking impressions of the limbs we are treating. The casts will only be on your child for approximately 20min and will then be quickly removed to use in the fabrication process.
How long will the casting and fitting/delivery appointments take?
We reserve one hour for most casting and delivery appointments. While they may not take this long, we want to be sure we can provide the quality service each patient requires. Certain items such as KAFO’s, TLSO’s and RGO’s will take longer to both cast and deliver and our front office staff will be sure to communicate this prior to your arrival based on the Rx provided by the physician.
What do I need to do to get authorization from my insurance?
Once we receive the prescription, insurance, and demographic information, we can take it from there. Our staff will take all the necessary steps to get the proper authorizations from the insurance companies and determine your coverage for the prescribed orthotics. If there is an out of pocket cost associated the orthotics your child is set to receive, we will be sure to provide an estimation prior to the delivery appointment so you can know what to expect and plan in advance. We do suggest you call your insurance as well to verify orthotic coverage.
What is the casting appointment like for my child?
All patients are thoroughly evaluated by our orthotists prior to casting. When the casting is set to begin, we will draw small marks on the child’s skin with an indelible pencil and put stockinette on the patient’s feet and legs. We then put a ribbon and small tube into the stockinette to create a barrier to the skin for when the cast will be removed.
We usually request our patients lay on their stomach during the casting for various types of AFO’s. While this may differ from previous experiences, this will allow the orthotist to achieve the best alignment of the child’s feet and ankles for the best fitting orthoses. Each limb will then be wrapped in a plaster bandage, one at a time, and takes approximately 5-8 minutes for the plaster to harden on each side. During this time, we hold the patient in a corrected alignment while the plaster is hardening to assure this corrected position is translated into the orthotics the child will receive. To remove the cast, we use a quiet cast cutter, or “tickle machine,” as we prefer to call it. It is important to know that the cast cutter does not spin, it only vibrates which is why it tends to tickle, not hurt.
We finish by taking foot measurements, cleaning up and answering any questions, or concerns. We understand that not all children are able to hold still for this process, luckily, we are well trained in such instances and will do our best to make this experience as quick and easy as possible for the entire family.
Do I need to bring anything to the casting or delivery appointment?
A favorite book or toy can help the child feel more relaxed during the casting appointment, which can be helpful. Also feel free to bring a tablet or phone with the child’s favorite music or videos, as they can watch/listen to this during the casting to provide a quality distraction to what is going on.
If the child is receiving daytime orthotics, we usually request shoes be brought to the delivery appt to assure we can assess the fit and watch the child walk if they are able to do so. At the casting appointment, the orthotist will discuss what size and style shoes are required to fit the new orthotics and if anything else is necessary to assure proper fit and function.
When will I be billed for the orthoses?
As a participating provider, our patients with active Medicaid or Children’s Special Health Care Service will not be billed for services rendered. Prior to the delivery of the new orthoses, our staff will notify you of any coinsurance/deductible/noncovered benefits prior to proceeding. We will bill your insurance(s) and ask for 50% of payment on any coinsurance/deductible due by you at time of the delivery of the orthoses. Once your insurance has paid their portion, we will send you an invoice with your remaining balance due.
Does my child need to be at the office to receive the new orthoses?
Yes, the child must be present at the delivery appointment of all custom orthoses. The orthoses will need to be fit on the child, checked for comfort, and final trimming needs to be completed to the proper size of the child’s foot. If your child is ambulatory, we would like to have them walk in the orthoses while here to check comfort, fit and to assure the shoes are fitting properly with the new AFOs inside.
Some off the shelf or custom measure items do not require the child to be present at time of delivery, however your orthotist will need to determine if your child qualifies for this. Many times, even if the child has been measured for non-custom items, it is still best for the orthotist to fit them to the child first and provide instructions to the parent to assure proper function going forward.
If my child develops red marks or complains of pain while wearing the orthoses, should we stop putting them on?
If at any time your child has red marks that do not go away after 30 minutes OR if your child begins to have complaints of pain while wearing the orthoses, an appointment should be scheduled at our office for evaluation as soon as possible. Our policy is to put a priority on these appointments, as minor adjustments may be the only thing required to correct the issue. Your child needs the benefits provided by wearing the orthoses to improve function and alignment as prescribed by the physician, which can only be accomplished if they are comfortable. Please call for an appointment as soon as possible if the child is experiencing these problems.
Need Support?
If you need additional questions answered don’t hesitate to call us at: 616-956-5556 or email us at: Office@ortho4peds.com.
