And so the story continues…My last blog about my son, N.S, stated he was to have surgery for his bone anchored hearing aids on March 20, 2014. Unfortunately, that did not happen. It was denied by the insurance company (buried in the exclusions under Durable Medical Equipment—DME). Not only was this a surprise to our family but also for the surgeon’s office AND all of this came to a head less than one week before his surgery date. Later we find out that it was our specific plan with this company (negotiated through my husband’s employer) and not all plans with this company.
Thankfully, we were still within a timeframe that we could enroll in a new insurance plan. I went online and researched almost all of the plans available. Ensuring that there were no exclusions listed under DME’s. I chatted online with representatives about specific plans and even called the insurance company and asked about specific codes under the plan I was considering. I was informed that the codes were covered. Two codes required medical necessity forms which the surgeon sends in when obtaining prior authorization. So…I enrolled myself and both children.
We received our cards in April and I scanned and emailed them to the surgery coordinator; hoping we would be able to reschedule surgery for mid-May. Of course, that did not happen. As of today (May 12, 2014) surgery is scheduled for Monday June 9th. But all is not a downer…last week I received an email from the surgery coordinator that she had called to start the authorization process and was given the authorization over the phone. Things are starting to look up, but as always, I will let you know.