I want a Baha. NOW!

[Kencutus]

Good luck, Denise!  You Rock!

[Jim Scott]

Denise ~

I'm awed by your tenacity and I hope it's amply rewarded with a positive result for your BAHA claim.   Well done!

Jim

[lawmama]

Oh goodness, Denise!!  I really, really hope your appeal works.  That is so frustrating.  It almost sounds like they wrote that provision to specifically dis-include Bahas and Cochlear implants, which seems so unfair. 

I called the other day and my whole file has fallen into a lag somewhere between the office where my Baha test was done and the billing office, so they haven't even sent it to my insurance for approval yet.  I'm hoping they'll get that done soon.

Lyn

[leapyrtwins]

Denise - and Lynn -

persistence generally pays off in requests for BAHA coverage.  For some reason, first requests for coverage are often denied, but subsequent requests are usually honored.

I guess insurance companies figure patients will just give up and call it a day.  Apparently they have no clue who they are dealing with 

Stay tough and hang in there,

Jan

[Denise S]

Lyn     Mine actually isn't an appeal.   Basically was told flat out NO because of what is in our contract.   The only way I could even get a written denial is if I were to HAVE the surgery, then the charges would come back denied.   I don't want to take that risk....can't afford it AT ALL.

But, I for some reason just thought I would call that OMS # that came in the folder of information and spoke with the lady who did my 'case'.  She said there is usually NO way to get around it "unless" my insurance may be self funded, then I can try through human resources.   What the heck, I took a shot and made a call.    I think the thing that is helping me out so far is that our insurance IS "partially" self funded.   Then, the HR Secretary (whom I never met and lives many states away) has sympathized for my young family since originally hearing of my tumors and surgery for the AN.  When she heard my explanation of the SSD, she sounded like she was in tears and vowed to do whatever she could for me.   So, I refer to her like my little angel....she is my advocate right now.      OF COURSE.....still no guarantee, but I have to try!!!!!

If it fails, there is one doctor more local who wants to start doing BAHA and has done none yet, so I thought 'maybe' he would work something out if I was his guinea pig      (can you tell I really need one.........more like I feel like I need one...........SSD & tinnitus just suck for me & my family so far)

I am crossing my fingers, but in the mean time I found out I have another condition that may take precedence over the BAHA.   Chiari Malformation and something else, but don't see neurosurgeon to know more until the 14th....ugh, more waiting.

thanks,
Denise