Author Topic: My doctor's office is making things very difficult!!!!!!  (Read 19621 times)

leapyrtwins

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Re: My doctor's office is making things very difficult!!!!!!
« Reply #15 on: October 01, 2009, 09:15:07 pm »
According to my husband's audiologist, hearing aids are  not covered by insurance.

You are correct, very few insurance companies cover hearing aids.  The BAHA, however, isn't a conventional hearing aid.  It's an implant and when classified this way, it is covered by many insurance companies.  My insurance company paid for my processor - and my BAHA surgery - 100%. 

Jan
Retrosig 5/31/07 Drs. Battista & Kazan (Hinsdale, Illinois)
Left AN 3.0 cm (1.5 cm @ diagnosis 6 wks prior) SSD. BAHA implant 3/4/08 (Dr. Battista) Divino 6/4/08  BP100 4/2010 BAHA 5 8/2015

I don't actually "make" trouble..just kind of attract it, fine tune it, and apply it in new and exciting ways

mandy721

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Re: My doctor's office is making things very difficult!!!!!!
« Reply #16 on: October 02, 2009, 07:04:17 am »
According to my husband's audiologist, hearing aids are  not covered by insurance.

You are correct, very few insurance companies cover hearing aids.  The BAHA, however, isn't a conventional hearing aid.  It's an implant and when classified this way, it is covered by many insurance companies.  My insurance company paid for my processor - and my BAHA surgery - 100%. 

Jan

Just my 2 cents, but I don't understand  insurers  don't cover hearing aids. In the case of SSD, both the Cros, Transear and BAHA  are designed to allow better hearing, but  since one is considered a surgical procedure it is covered by some insurers while the non-implanted devices are not. 
Husband diagnosed 5/30/09 with 3.2cm right AN
Surgery at  Columbia Presbyterian 8/4/09
Platinum eye weight implant - 8/17/09
17 days in hospital and rehab
SSD, facial weakness, some tinnitus, headaches , balance and eye problems

lori67

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Re: My doctor's office is making things very difficult!!!!!!
« Reply #17 on: October 02, 2009, 07:07:39 am »
A BAHA is technically considered a prosthetic device, so it should be covered by most insurance plans.

It doesn't make sense to have to pay $500 for the processor, when the processor itself costs in the range of $3000 - $4000.  That would either mean your insurance paid all but $500 (maybe a deductible) or they are giving you a huge discount - which I'm guessing isn't the case.  Why would you sell something for $500 when it cost you $4000 to begin with?  I don't think there are too many doctors that are THAT generous.

Lori
Right 3cm AN diagnosed 1/2007.  Translab resection 2/20/07 by Dr. David Kaylie and Dr. Karl Hampf at Baptist Hospital in Nashville.  R side deafness, facial nerve paralysis.  Tarsorraphy and tear duct cauterization 5/2007.  BAHA implant 11/8/07. 7-12 nerve jump 9/26/08.

leapyrtwins

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Re: My doctor's office is making things very difficult!!!!!!
« Reply #18 on: October 02, 2009, 09:24:23 pm »
the processor itself costs in the range of $3000 - $4000.  That would either mean your insurance paid all but $500 (maybe a deductible) or they are giving you a huge discount - which I'm guessing isn't the case.  Why would you sell something for $500 when it cost you $4000 to begin with?  I don't think there are too many doctors that are THAT generous.

Lori -

I agree with you.   I do have to say though, that when I asked the Cochlear reps @ the ANA Symposium what an upgrade from the Divino to the BP100 would cost me they said I'd have to talk to my doctor about that.  While I doubt that a doc is only going to charge $500 for a processor they can charge $4,000 for, they must have some kind of profit margin that they may be willing to reduce.

Kathy -

have you been able to make any progress with your doctor's office on this issue?

Jan
Retrosig 5/31/07 Drs. Battista & Kazan (Hinsdale, Illinois)
Left AN 3.0 cm (1.5 cm @ diagnosis 6 wks prior) SSD. BAHA implant 3/4/08 (Dr. Battista) Divino 6/4/08  BP100 4/2010 BAHA 5 8/2015

I don't actually "make" trouble..just kind of attract it, fine tune it, and apply it in new and exciting ways

kma

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Re: My doctor's office is making things very difficult!!!!!!
« Reply #19 on: October 05, 2009, 11:14:03 am »
Hi everybody~

Sorry it's taken me so long to respond.  Fall colds and flu and allergies have taken over my house.  Ugh!! 

I have gotten nothing but a pain in the bum from my doctor's office.  They tell me that the $500.00 fee covers the
fitting appointment and showing me how to use the processor and any "help" I might need with it down the line. 
They still insisit that they don't bill insurance because insurance "never" covers it.

I spoke with the hospital and the doctors office and requested copies of what they've charged my insurance so far
for my BAHA.  I got what the hospital sent but haven't gotten what the doctor sent.....yet.  Interesting!!  The hospital
charges were what I expected......meds, o.r. charges, supplies, etc.  Nothing out of the ordinary.

Blue Cross still tells me to try to submit the charge.  I find it funny that the insurance company is being more helpful and
reasonable than the doctor.  AND..........if I tell the doctor that insurance says to bill it ~ HELLO ~ why can't they just
bill the insurance company.  Heck, if it's rejected, I'd still be responsible for the bill and I've paid all of my bills on time. 

I'm actually thinking of calling Coclear and seeing if there is some sort of patient advocate that might be able to help me
make heads or tails out of what's going on. 

I know the $500 has nothing to do with Divino vs BP100 because they don't know which one I'm getting yet.

I'm really getting annoyed.   :P

Signed,

Crabby Kathy in Michigan
Retrosigmoid on 02-06-09 by Dr. LaRouere (Michigan Ear Institute) and Dr. Pieper.  Perfect hearing, perfect balance, no tinnitus and no headaches before surgery.  Right SSD, loud tinnitus and crazy headaches after surgery.  BAHA surgery 07-29-09 ~ still working on tune-ups...don't love it ~ YET!!

Sefra22

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Re: My doctor's office is making things very difficult!!!!!!
« Reply #20 on: October 05, 2009, 04:13:44 pm »
Hey Kathy,
Sorry to hear that you're still getting the runaround. I have been to see my audiologist 3 times since I got my BP100, and every time the office has submitted the visit to my insurance. In fact, they don't even charge me a co-pay to see her. I haven't seen any statements yet, so I'll let you know if I get rejected.

Lisa
Lisa from Portland, Maine age 46
Diagnosed June 2006
15mm X 17mm AN right side 80% hearing loss
GK March 14,2007 Dr. Noren, Providence RI
1 Year follow-up MRI shows "slight shrinkage".
2 Year follow-up MRI shows "No Change".
3 Year follow-up MRI "stable".
BAHA surgery 4-22-09 BP100 Sept. 2009

moe

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Re: My doctor's office is making things very difficult!!!!!!
« Reply #21 on: October 05, 2009, 06:10:58 pm »
Kathy,
Was hoping for better news. Sorry they are still  being so uncooperative and unwilling :'( and stubborn- you name it.  Sorry also that YOU have to do all this work.
They need a kick in the arse.
Hang in there- calling Coclear sounds like a good idea.
Hang tough, don't give up!
Maureen
06/06-Translab 3x2.5 vascular L AN- MAMC,Tacoma WA
Facial nerve cut,reanastomosed.Tarsorrhaphy
11/06. Gold weight,tarsorrhaphy reversed
01/08- nerve transposition-(12/7) UW Hospital, Seattle
5/13/10 Gracilis flap surgery UW for smile restoration :)
11/10/10 BAHA 2/23/11 brow lift/canthoplasty

leapyrtwins

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Re: My doctor's office is making things very difficult!!!!!!
« Reply #22 on: October 05, 2009, 09:40:44 pm »
I find it funny that the insurance company is being more helpful and
reasonable than the doctor. 

Kathy -

this IS very strange.

I have a contact @ Cochlear (met her @ the ANA Symposium) - I'll PM you her information.  I'm not sure if she can help, but she may be able to direct you to someone @ Cochlear who can.  It's worth a try.

Jan
Retrosig 5/31/07 Drs. Battista & Kazan (Hinsdale, Illinois)
Left AN 3.0 cm (1.5 cm @ diagnosis 6 wks prior) SSD. BAHA implant 3/4/08 (Dr. Battista) Divino 6/4/08  BP100 4/2010 BAHA 5 8/2015

I don't actually "make" trouble..just kind of attract it, fine tune it, and apply it in new and exciting ways

Melissa778

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Re: My doctor's office is making things very difficult!!!!!!
« Reply #23 on: October 06, 2009, 09:35:30 am »
Kathy,

I'm set to have my BAHA tomorrow through the saem office as you, they did tell me of the $500/fee.  After speaking with my insurance they stated that they cover all charges for the BAHA and that I should not being paying a penny either.  Looks like I have a long road ahead of me as well.  Had I known this I would have had the BAHA done through another audiologist in my area......Let me know how things go with this!!

Melissa
1.6cm X 1.6cm diagnosed Jan 30 2008
Translab Surgery scheduled for May 15th with Surgery went well, got ALMOST all of it.
GK to zap the rest on 10/22/08
2010 MRI showed no new growth tumor measuring at that time at 1.1 x .4
2011 Holding steady
2012 new growth 1.7 x .7 :( :(

OTO

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Re: My doctor's office is making things very difficult!!!!!!
« Reply #24 on: October 06, 2009, 06:56:09 pm »
If you still need the insurance codes...  look for a discussion thread by Tamara.   She posted some of the Insurance codes, and I think if you PM her, she can get you the codes you need.    The discussion thread is buried back about 3rd or 4th page of threads...  Subject:  Insurance Codes

leapyrtwins

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Re: My doctor's office is making things very difficult!!!!!!
« Reply #25 on: October 07, 2009, 07:27:38 am »
Retrosig 5/31/07 Drs. Battista & Kazan (Hinsdale, Illinois)
Left AN 3.0 cm (1.5 cm @ diagnosis 6 wks prior) SSD. BAHA implant 3/4/08 (Dr. Battista) Divino 6/4/08  BP100 4/2010 BAHA 5 8/2015

I don't actually "make" trouble..just kind of attract it, fine tune it, and apply it in new and exciting ways

Rc Moser

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Re: My doctor's office is making things very difficult!!!!!!
« Reply #26 on: November 22, 2009, 04:11:11 pm »
I agree with Jim you need to fire that doctor and take your business elsewhere and spread the love about that clinic.  From now on when I go to the doctor I going ask up from do you except insurance and
9/17/03, 4.5CM, Translab, OU Medical Center, Dr. (the ear man) Saunders and Dr. B. (the BrainMAN) Wilson  along with about 4 other Doctors that keep me going for 18 hours.

Sue Vogel

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Re: My doctor's office is making things very difficult!!!!!!
« Reply #27 on: November 30, 2009, 10:04:35 pm »
I am just starting the process to get my BAHA, and my doctor's office also charges a $500 fitting fee at the time of fitting the processor.  They claim it is not covered by insurance carriers.  What is the real story here?
SUE
3 cm left side
Translab. surgery 10/13/08
Dr. Gantz/Dr. Woodson
Univ. of Iowa Hospitals and Clinics
SSD, adjusting to balance issues
BAHA surgery 1/29/10 Dr. Gantz/Dr. Woodson (dynamic duo)

leapyrtwins

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Re: My doctor's office is making things very difficult!!!!!!
« Reply #28 on: November 30, 2009, 10:36:20 pm »
This post was the first time I've ever heard of something like this.

My neurotologist didn't charge me any kind of fee for "fitting" my BAHA and neither did the audiologist I saw that day.  I went back and checked my records, and all I paid for on my BAHA Gotcha Day was a typical office visit.

I am going to upgrade my processor in January and was quoted a price for the BP100 with no mention of a "fitting fee" - so I am confident that my doctor's office hasn't changed their policy.

I, too, am anxious to hear the real story here.

Good luck with the BAHA, Sue.  From personal experience, I can tell you that you'll love it  ;D

Jan
« Last Edit: November 30, 2009, 10:38:18 pm by leapyrtwins »
Retrosig 5/31/07 Drs. Battista & Kazan (Hinsdale, Illinois)
Left AN 3.0 cm (1.5 cm @ diagnosis 6 wks prior) SSD. BAHA implant 3/4/08 (Dr. Battista) Divino 6/4/08  BP100 4/2010 BAHA 5 8/2015

I don't actually "make" trouble..just kind of attract it, fine tune it, and apply it in new and exciting ways