ANA Discussion Forum
General Category => Insurance => Topic started by: Nancy T on October 29, 2007, 10:56:04 pm
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Hi all. How much did your BAHA processoror cost, and did you have to pay for it, or did your insurance cover it?
My neurotologist's office told me that the processor costs $10,000 via the hospital (because he does the surgery in the hospital and the hospital provides the BAHA hardware--marking it up, of course!).
But on this forum I've seen more in the neighborhood of $4,000.
I'm probably going to try to switch to Kaiser insurance and see if they'll pay for a BAHA. If I have to pay $4000 for the processor, I might go for it, although it would be very difficult for our family financially. But if I have to pay $10,000--no, too much! There are two other neurotologists in town who do the BAHA surgery and maybe they do it in their office and thus avoid the hospital markup.
I am really flailing in the dark here until I get more information and/or go on Kaiser.
Any advice/experiences welcome!
Nancy T.
P.S. I did not have an acoustic neuroma. I had a sudden, severe-to-profound sensorineural hearing loss in one ear 8 years ago, etiology unknown.
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Yes the processor cost about 4,000$ (give or take a 1000) .. the surgery is the variable here.... normally it runs about 8-10,000$ ....
most of the time, the surgery is covered under insurance ... the processor is not .. but it is sometimes ... I was a lucky one!, the BAHA surgery was done at the same time as the AN .. so it was just a line item on the same bill .... and was paid....
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Nancy T
Like Joef, I had my BAHA surgery at the same time as my AN surgery and the insurance paid it all less my deductable. I never got a detailed bill from the hospital so I can't help with the exact cost. My insurance does not pay for hearing aids but Dr. Brackmann coded it so they would.
Ellis
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Thanks, Joe and Ellis... it sounds like there is a lot of variation in what is paid for and under what circumstances.
I hate to change insurance (which will cost me $900 a year in lost reimbursement for having other insurance) just on the CHANCE that it will pay for BAHA surgery & possibly also the processor, but it seems there is no way to know for sure whether it will pay until you put in a request as a member. A $900 gamble.
Nancy
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I haven't got my processor yet and my Dr.'s told me it was about 5,000 dollars and I would have to pay for it out of pocket. I'm from a very small town so there was a benefit for me so hopefully that will cover most of it!
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Ellis,
Do you know what CPT codes were used to get insurance payment? It might be nice if other drs knew.
Tamara
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Sorry Ellis - I'm going to jump in on this one!
Tamara - the code they should be using is 69714 - Implant, Temporal bone with stimulator.
This is different than being coded as a regular hearing aid, because the BAHA is considered a prosthetic and most insurances have some coverage for that.
I know the code because the dimwit at my doctors office who does the billing submitted it incorrectly - one number off - and caused me to get a bill for $7000. after 3 months of playing pass the buck - medical billing said it wasn't their error - insurance said it wasn't their error - aforementioned dimwit said it wasn't her error....well, it was her error. It was resubmitted and paid for!
Hope that helps.
Lori
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Thanks for the code... I have asked for and not got it from doctors office or hospital and the
insurance people last time I talked to them had asked me for it ...crossing my eyes it helps
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I got a BAHA in January 2007. My insurance paid for everything, but the attachment. I believed that they should pay, so I fought it, along with a BCBS Rep. from the County which I work for. He worked with the insurance and CPT codes with the Hospital and...10months later I got my $4200.00 back. How great was that. Don't give up. I am so proud of myself for sticking with it.
I knew I had to pay, but I wanted the BAHA anyway. Look how great it turned out.
Laurie
AN in 1/2004
Translab procedure
House Ear Clinic