Soundbite

[Sue Vogel]

So Steve...could you clarify your message for me...Are you saying that both BAHA and Soundbite are appropriate for us SSD folks with sensori neural hearing loss even though it says that it is not for this type of hearing loss?  My Blue Cross specifically rules out paying for a BAHA for an individual with a sensori neural hearing loss.  I don't understand this.  My audiologist said if my deafness was due to chronic ear infection in my middle or outer ear that Blue Cross would pay for the BAHA but not for me since my hearing loss was in my inner ear.  I don't understand the discrimination.  Why do they care what caused the deafness?  It's still a deaf ear and can be remedied by the BAHA.  My insurance says it is "not medically necessary for those with sensori neural hearing loss."  I don't understand "medically necessary" - for whom?  

SUE

[saralynn143]

I have every confidence that Steve can knit and post simultaneously. Right, Steve?

Sue, I think it is worthwhile for you to appeal to your insurance company on the grounds that you would benefit from the lesser-known conductive property of the BAHA. Surely there is something out there that you can use as documentation.

Meanwhile, have you participated in a BAHA trial? If you can show that helped you, then it would follow that the surgery would be of benefit also.

Sara

[leapyrtwins]

Wow, Jan, I'm stunned. I might have expected that an overnight stay with general anesthesia might rack up a charge like that. But holy cow.

Sara -  as I said earlier, that was the price before my insurance company discounted it.  After they discounted it, it cost less than $10,000 - for the surgery and the device - and I never paid one cent. 

I don't think there is such a thing as a BAHA trial since the BAHA is a tried and true product - unlike the SoundBite - it's been around for a long time (many, many years in Europe before it came to the states) so there is nothing to "try".  You can demo the BAHA, but that's something different.

Sue -

the BAHA is considered medically necessary for those who are SSD - BUT that does not mean that your insurance company is required to cover it.

My insurance company's biggest question was "are you SSD?"  I quickly referred them to my AN surgical report which clearly stated that I was SSD as a result of my surgery.  That coupled with the information my doctor sent them on what the BAHA would do for me and why I needed it was enough information for them.

Did you ever find out if your insurance company covers Cochlear Implants?  If so and they are refusing to cover a BAHA you have a better discrimination case based on that argument than you'd have arguing chronic ear infections. 

Also, did you ever contact Cochlear and ask for help in getting Blue Cross to cover a BAHA?

Jan

[saralynn143]

Jan, I didn't mean a medical trial, but the deal where they put one on a headband so you can get an idea of how it works.

Sara

[leapyrtwins]

Sorry, guess I misunderstood.  That would be a BAHA demo.

[saralynn143]

Yes, demo, thanks. I was thinking "try it out" and "trial" seemed like the right word at the time.

It seems reasonable that if Sue's hearing improved during a BAHA demo, then an implant and device would work as well. Of course insurance companies are not always known for being reasonable.

[sgerrard]

Sue,

I am just quoting web sites.

The first sentence of the last paragraph on this page, at the SoundBite web site:
http://www.sonitusmedical.com/product/technology.cfm
"SoundBite hearing system is intended for patients who suffer from single sided deafness,..."

The first sentence of the last paragraph on this page, at the Cochlear web site, regarding who can use a BAHA. You need to click on the blue SSD tab, and find the paragraph at the bottom with the title "The Baha® solution for SSD"
http://products.cochlearamericas.com/baha/introduction-to-baha/who-can-use-baha
"Baha®, a CE marked and FDA cleared solution for SSD, provides a unique benefit. The Baha device is placed on the deaf side behind the ear, and transfers sound through bone conduction, stimulating the cochlea of the normal hearing ear."

This is not the more common use of these devices, which is to bypass a conductive hearing loss on the same side as the device. Audiologists and apparently insurance companies are not always aware of their use with SSD. As Jan suggested, contacting the companies about insurance issues may help.

And Nancy is right, I should be knitting. I am so far behind on it now, it is hard to get going.

Steve

[leapyrtwins]

And Nancy is right, I should be knitting. I am so far behind on it now, it is hard to get going.

Heck, even Santa's elves take a break now and then.  Tis the holiday season Steve, let the needles rest for a while.

I never know how you fit it all in - moderating and posting on the Forum, knitting hats for your fellow Forumites - and then of course there's your day job.

Thanks for all you do around here!

Jan

(Hijack over, Phyl) 

[NancyMc]

Okay, I just re-read the Soundbite description.  It refers to transferring sound to both cochleae, but I guess if one is missing, we still have the other one.

Knit one, purl one . . .