Author Topic: Wanting BAHA, but insurance frustrations  (Read 2366 times)

Denise S

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Wanting BAHA, but insurance frustrations
« on: May 25, 2010, 10:40:10 am »
Basically I'm just here to vent a minute  :)
I have had the Cochlear OMS support helping me with trying to get a BAHA !!
Things have just been crazy since started all this in March and had a denial.      NOW something changed in my insurance as of 5/15/10 and sometimes BAHA "may" be covered.   Problem is that it is such a grey area no one can get a definite answer, ugh!!!!!          

The next step is to have my doctors office write a letter of predetermination including medical necessity, etc.  to see what insurance has to say.      Basically all things with insurance seem to some down to one goofy little code number or terminology, crazy!!

Now off for more waiting games.........wish me luck (and I hope they hurry this time)  ;D


Thanks for "listening"!
Denise (MI)


* Denise:  I changed the color of the text to make it easier to read.  J.S.
« Last Edit: May 25, 2010, 12:13:16 pm by Jim Scott »
W&W 2 yrs. (due to watching other brain tumor: it's stable)
Left AN:  1.2 cm (kept growing during 2 yr.)MIDDLE FOSSA  11/9/09;  Michigan Ear Institute Dr. Zappia & Pieper
SSD, mild tinnitus, delayed onset of facial paralysis lasting 3-4 weeks, no tears AN side
BAHA surgery 10/2/12 Dr Daniels G.R.,MI

leapyrtwins

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Re: Wanting BAHA, but insurance frustrations
« Reply #1 on: May 25, 2010, 05:51:26 pm »
Don't give up Denise.

The fight for insurance coverage of a BAHA is well worth it.

And it's a fact that first requests are often turned down, while subsequent ones are usually granted.

Keep the faith!

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

Kencutus

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Re: Wanting BAHA, but insurance frustrations
« Reply #2 on: May 26, 2010, 02:05:47 am »
Don't give up.  Keep fighting it even if you have to wait 4 or 5 years.  I know it sucks but that's what I had to go thru but that's doesn't mean you have to go down the same road as I did.  You might get it a lot sooner than I did, who knows. Whatever you do, don't take "No" for an answer. ;)
"Hearing Resistance is Futile!"
Treacher Collin's Syndrome
First surgery left side 12-08, Baha Intenso 3-09
Abbutment came loose on 5-09
Bilateral Baha surgery 6-09 Baha refitted 9-09
Richard & Mark Wiet MD from Ear Institute of Chicago.

AIteach

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Re: Wanting BAHA, but insurance frustrations
« Reply #3 on: May 26, 2010, 03:55:30 pm »
Just wanted to wish you good luck!!! (Keep fighting!!) I know insurance issues can be so draining.  Many times it's just a matter of who will hold out the longest.  I spent a year and a half trying to get payment for a medically necessary $14,000 helicopter trip.  I finally won out.  (Thank God)  Just wanted to encourage you today  ;D
Lauren
diagnosed Feb. 2010
wait and watch
tumor: 6mm
Fall 2018 still W&W 8mm
August 2021 grew to 1.2cm
8/21 Treatment: Fractionated SRS

lawmama

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Re: Wanting BAHA, but insurance frustrations
« Reply #4 on: May 29, 2010, 07:19:17 pm »
Denise,

So sorry you are having so much trouble, but keep at it.  I am STILL fighting with my insurance company to get all of the bills from my original surgery paid, so I sympathize with your insurance frustrations. All I can say is keep bugging them and if you don't like what one person tells you, call back another time and speak to someone else.  I have been amazed at how much variation there is in the "help" you get from the people who answer the phone. 

Keep us updated!

Lyn
9mm X 7mm tumor (left side), diagnosed 10-15-09
Retrosigmoid on 12-14-09 by Drs. Antonelli and Lewis (my heroes!)
Shands in Gainesville, FL
SSD, but no facial issues.  Mild tinnitus.