ANA Discussion Forum

General Category => Hearing Issues => Topic started by: lawmama on February 13, 2010, 08:47:31 am

Title: I want a Baha. NOW!
Post by: lawmama on February 13, 2010, 08:47:31 am
Am I being reasonable?  My ENT seems to want me to try other types of hearing devices before I go for something permanent, but my insurance won't pay for them, I cannot afford them on a student budget, AND I'm pretty certain that I will eventually want a Baha anyway.  Why wait?  I don't want a visible hearing aid, and from what I understand the quality of sound is superior with a Baha.  I've done my research.  I want a Baha!  Do you think I am rushing this? 

I am surprised at how much being SSD has caused problems in my life.  I can hear during lecture fine because it is only the Professor speaking, but if someone in class asks a question I can't tell where it is coming from (the lecture halls are large).  Also, my social life is almost nil because of this.  I attended a banquet a few weeks ago and it was a miserable experience.  Beside the fact that I couldn't hear the person on my left when he was speaking to me at dinner, during the cocktail hour the chatter and noise from the room wiped out my hearing and I ended up just nodding and smiling instead of making everyone yell at me.  I'm already sick of this and I don't see why I need to wait and be miserable any longer before I do something about it. 

I have an appointment on the 22nd of this month and I'm planning on marching in an demanding a Baha.  I don't see why I should wait.  This is what I want.  I have educated myself about the various options.  Why wait?  So, I ask again, am I being reasonable? 

Sorry about the rant.  I'm just frustrated, I suppose.  Honest opinions!

Lyn
Title: Re: I want a Baha. NOW!
Post by: tenai98 on February 13, 2010, 09:17:37 am
hi Lyn
My ENT also made me try out the bi cros hearing aid whch I didnt like. My insurance does pay for conventional hearing aids but does the BAHA...I just insisted on the BAHA...I did try the cros but got my BAHA instead...
I would demand the BAHA...its what YOU want not what the ENT wants...
JO
Title: Re: I want a Baha. NOW!
Post by: leapyrtwins on February 13, 2010, 09:57:07 am
Lyn -

chances are your ENT has never worn a BAHA - or any other type of hearing "device" for that matter - so I personally don't think he/she has the right to tell you what you should do.  Suggestions are one thing, but it's your hearing and your decision.

Does your ENT do BAHA implants?  Any doctor I've ever talked to who does them has told me that their patients love the BAHA.  My doc has done over 250 implants and he told me only 1 person decided after the fact that it wasn't for her.  That speaks volumes in my mind.

I was miserable prior to getting my BAHA - I found it very hard to adjust to being SSD - and it sounds like you feel the same way.  Although some people don't experience this, those who do should definitely do something about it.

I regret I didn't get the BAHA sooner (had my surgery 9 months post op because I was waiting on insurance approval) and I don't think you should wait.

However, it's important to remember that while the BAHA is a huge help, it is NOT like your normal hearing was.  Don't set your expectations too high.

Jan
Title: Re: I want a Baha. NOW!
Post by: lawmama on February 13, 2010, 01:39:30 pm
Thanks for the replies.

Jan, good point about not getting my hopes too high.  Honestly, any improvement would be very welcome.  My main concern is that I have something that doesn't show too much (that I can camouflage) and something that allows me to operate normally in my daily life.  I just don't think I would be happy with an over-the-ear hearing aid.  I know that is a fantastic option for thousands of people, but I think for my own life and my needs a Baha would work better for me.

Yes, my ENT does Bahas.  I don't think he is hesitant because of the Baha itself, I think he just wanted me to heal and think about it carefully before I made a decision.  I'm pretty much all healed.  And I've thought about it.  I still want it!

Jo, thanks for sharing your personal experience.  I really believe he will be more than happy to let me do this when I show him that I have done the research and this is an educated and carefully thought out decision.  I am the type of person that very carefully considers decisions before I make them, but it doesn't take me long to do it.  I do a ton of research and then pull the trigger, so to speak.  :D

Thanks again.  I will let you all know how it goes after the 22nd.

Lyn
Title: Re: I want a Baha. NOW!
Post by: ombrerose4 on February 13, 2010, 01:55:04 pm
Hi, I agree that you should demand the BAHA if that's what you want. I had my BAHA surgery in January and I am counting down the days till I get to use it. I go to school also, so I understand how you feel. Sometimes I feel like I am being rude cause I can't hear and reply to what people are saying. And in social situations I feel completely shut out on my SSD side. And I can't take part in discussions because I sit right in front of the professor but can't hear behind me. So stick to your guns and get the BAHA. I found the demo (tried it twice) amazing! Let us know how it goes.
Title: Re: I want a Baha. NOW!
Post by: Jim Scott on February 13, 2010, 02:17:10 pm
Lyn ~

As I see it, your ENT doesn't make the final decision on this, you do.  So, to answer your question, yes, you're being reasonable.  I wish you complete success in your quest for better hearing through modern technology.:)

Jim
Title: Re: I want a Baha. NOW!
Post by: Kencutus on February 13, 2010, 03:14:49 pm
I say "Go for it!"  If that' what you want, go for it!  No one should deny you from getting what you want.  I fought for 4 years with my insurance company and won!  I would not take "No" for an answer.  It's the best investment I ever made and I don't regret it.  ;)
Title: Re: I want a Baha. NOW!
Post by: leapyrtwins on February 14, 2010, 04:20:40 pm
Don't get me wrong, the BAHA is incredible - my thoughts are similar to Ken's in that area; it's one of the best investments I ever made.

You just don't want to get into the mind set that the BAHA will give you back your normal hearing, because as wonderful as it is, it won't.

Dr. Sam (Sam Rush) cautioned me about this before I got my BAHA and I'm thankful he did.  I found the demo phenomenal but I also was aware of the BAHA's limitations.

Jan
Title: Re: I want a Baha. NOW!
Post by: lori67 on February 15, 2010, 02:37:48 pm
Jan brings up a very important point.

While I am all for a BAHA (obviously, since I have one!), you have to expect that it has limitations.

Chances are, you will still not be able to tell who is talking in the lecture hall because for most people, it will not restore directionality.  My doctor told me that for some it does - for me, not so much.  The good thing though, is that you may be able to hear the person better in the first place, even if you can't figure out where they are sitting.  As far as banquets - I always have to turn mine off when it gets really loud. All it does, like most aids, is amplify the noise.  I understand the BP100 might be better at filtering out the unwanted noise, but I don't have any experience with it, so I'm not sure.  I do find it helps at a dinner table, as long as it's not too noisy in the room to begin with.  I am able to hear the person on my deaf side.  I can't always hear everything said, but usually enough that I can follow along with the conversation.

As long as you go into it with reasonable expectations I don't think you'd be disappointed.

So, you're the consumer - tell your doctor that's what you want.

Lori
Title: Re: I want a Baha. NOW!
Post by: Denise S on February 16, 2010, 08:53:06 pm
Curious what other options he thinks you should try (spend your money on) first?  To my knowledge for our type of SSD is only the CROS, BAHA, and newer TRANSEAR.

I mainly ask because at my 3 month post op yesterday my neurotologist set me up with more info., etc. for the BAHA.   At Michigan Ear Institute they have had great results with the device itself.    The when meeting with the audiologist about it (they fit me in while there because they are about 3 1/2 hr. away), she too said it would be the very best recommended over CROS due to being younger.  (they haven't done any Transear yet, just got info. and updates last month).

Have to say too though....both said the same as someone previous that the sooner you get it, the easier it is for your brain to readjust because it hasn't been totally readjusted to the SSD for a long time.       

I have to say I wear glasses, and never thought of that issue.  BUT, I seen one person's picture on Facebook that looked like her abutment was way, way behind her ear......more toward the middle of her back of her skull.  Now that looks way uncomfortable.

Since it is such a time consuming process, at least insist they start the paper work.   


Title: Re: I want a Baha. NOW!
Post by: leapyrtwins on February 17, 2010, 08:10:01 pm
I have to say I wear glasses, and never thought of that issue.  BUT, I seen one person's picture on Facebook that looked like her abutment was way, way behind her ear......more toward the middle of her back of her skull.  Now that looks way uncomfortable.

Denise -

wearing glasses and a BAHA generally isn't an issue.  As I mentioned earlier, I wear both sunglasses (on a daily basis) and eye glasses (occasionally) and neither interfere with my ability to wear my Divino.

Placement of the BAHA abutment is generally behind the ear, but if the surgeon finds that the skull in that area isn't "sufficient" he/she may place the abutment further back on the skull.  Although this is kind of like the exception to the rule, my good friend Lori (lori67) has such a placement.

Here's one of my favorite BAHA links; you might find it helpful.  http://www.umm.edu/otolaryngology/baha.htm   It gives a nice view of the usual placement.

You should also check out www.cochlearamericas.com and the Cochlear Community - lots of good information there on both BAHAs and Cochlear Implants.

There's a BAHA user's support group http://www.baha-users-support.com/cgi-bin/2bb/2bb.cgi that has a lot of very useful information, too.

Jan
Title: Re: I want a Baha. NOW!
Post by: Denise S on February 17, 2010, 08:51:49 pm
Jan, thanks for the extra sites to visit.

I am actually overwhelmed at how great the Cochlear people are.   I got some info. from audiologist, but e-mailed via that website last night and got 2 posts back today with additional info. and they will be mailing me stuff.   They also pointed me in the direction to find the listings of who all in Michigan deals with BAHA.   Seems like that is most of what I did today was research on that, and updated my blog about it too.

I will BE SURE to add those other sites to check out, thanks again!
Title: Re: I want a Baha. NOW!
Post by: Mei Mei on February 18, 2010, 11:38:47 am
From a practical viewpoint and looking at these pictures, do you feel comfortable shampooing with the BAHA in place?  Is it at risk for falling out or damage or site infection?

Mei Mei
Title: Re: I want a Baha. NOW!
Post by: tenai98 on February 18, 2010, 11:50:37 am
the BAHA is removed before shampooing your hair....or for any physical activity....I wont be wearing mine fishing or atving.
JO
Title: Re: I want a Baha. NOW!
Post by: leapyrtwins on February 18, 2010, 06:21:25 pm
Mei Mei -

I'm not sure if you are wondering about shampooing with the device (tiny hearing aid) attached to the head or not.

As Jo said, you would remove the device.  It's quite costly and in addition, isn't waterproof - at least not waterproof enough to be drenched in a shower, swimming pool, or downpour.

The titanium abutment calcifies to the skull - usually within 90 days post op - and it's in there "for good".  There are rare cases of the abutment coming out of the skull, but it generally doesn't happen.  I once read that if you want to remove the abutment by any means other than surgical, you'd have to actually remove the piece of skull that it's calcified to.

The abutment isn't uncomfortable at all and in my case it's become just another part of me.  I don't think about it on a daily basis.  It only sticks up from the skull about 1/8" - if that.  Immediately post op it sticks up a little more, but it "sinks" in a few days or weeks. 

Infections can happen, most often while the site is healing post op, but they are usually treated pretty easily and pretty quickly.

I'll have my BAHA implant for 2 years on 3/4/10 and haven't had any infections or problems with it whatsoever.

Jan 

Title: Re: I want a Baha. NOW!
Post by: Pooter on February 22, 2010, 11:17:54 am
Jan,

I looked at your first link showing the 'normal' placement, and that appears to be right where my 'dent' in my skull is from surgery..  So, would the doctor the abutment higher or further towards the back?  I'm still exploring options and may just talk to my surgeon when I go in for my annual (he's on the list of doctors from Cochlear) so he does the implant surgeries also..

Thanks,
Brian
Title: Re: I want a Baha. NOW!
Post by: leapyrtwins on February 22, 2010, 12:08:48 pm
Brian -

my abutment is located in the "dent" in my skull from my AN surgery.  I have a little "hardware" in that general area from the retrosigmoid approach, but it hasn't been an issue.  One of the screws is pretty close to the surface of my skin, but if it ever pops through, my doc will just remove it with a screwdriver.

I don't think it's a concern, but obviously you should get your doctor's take on this.

Jan
Title: Re: I want a Baha. NOW!
Post by: lawmama on February 22, 2010, 03:43:08 pm
My Baha evaluation was today.  The audiologist tested me with a Divino model (I think that's what it was, although she said I will be getting a BP100 if it all works out).  It was pretty fantastic!  I can't believe how well I could hear, even with my good ear plugged.  At first it sounded a little unnatural, but it was funny how fast I adjusted to the sound/feel of it.  By the end of the hearing test I didn't want to give it back.  She said I am a great candidate for Baha, so now it all comes down to the insurance issue. 

Keep your fingers crossed for me, everyone.  I am very excited about this!  I know the Baha isn't like having my hearing back, but I am really jazzed about the potential to hear sounds from my left side again.  It seems like a miracle to me.

Lyn
Title: Re: I want a Baha. NOW!
Post by: saralynn143 on February 22, 2010, 03:46:43 pm
Great news, Lyn. I hope it works out for you.

Sara
Title: Re: I want a Baha. NOW!
Post by: saralynn143 on February 22, 2010, 03:49:18 pm
Also, Sue (vogstar5) wrote recently about how her doctor persuaded her insurance company to pay for her BAHA. If your insurance company denies you, you might get some hints from her.

Sara
Title: Re: I want a Baha. NOW!
Post by: ombrerose4 on February 22, 2010, 03:50:52 pm
I am so happy your BAHA evaluation went so well. I remember the day I had mine, I was so amazed!. My BAHA GOTCHA date is coming in about six weeks (I was lucky- my insurance covers all of it). I hope your insurance company makes it easy for you. Let us know how it goes. Good luck!
Title: Re: I want a Baha. NOW!
Post by: lawmama on February 22, 2010, 04:39:09 pm
Thank you, both!

Sara, I'm on a student plan with Aetna that specifically list "implants" as covered.  Woe to them if they try to deny me because I can be quite a thorn in the paw.  (I don't mind writing a letters, filing appeals, and/or making dozens of phone calls if it gets me what I want.  I'm a law student, therefore I am well trained in being a pest.)   ;D :D

ombrerose4, I have been following your other post.  I can't wait to hear how your big day goes.  I am very excited for you and I can't wait to hear how your experience goes.  From what I understand, the best case scenario will still leave me with $500 out of pocket (the programming isn't covered), plus my deductible costs, but I am hopeful that the rest will be covered.  It is still far cheaper than any other type of non-covered hearing aid would be.

Thanks again for the supportive comments.  I am really and truly excited after a chance to see what the Baha really sounds like.

Lyn
Title: Re: I want a Baha. NOW!
Post by: leapyrtwins on February 22, 2010, 07:35:45 pm
Lyn -

I'm glad you liked the demo.  I found it pretty miraculous myself  ;D

If you need insurance help, the people @ Cochlear will be more than happy to help you.  Don't hesitate to ask them.

Jan
Title: Re: I want a Baha. NOW!
Post by: Mei Mei on February 23, 2010, 10:51:32 am
I went for my Post Op check up yesterday at Hopkins with both my ENT and Neurosurgeon and they gave me an audiogram and let me try the BAHA for half an hour.  It was great.  I could hear a whisper.  They scheduled me for follow up in June.   I'm still wondering about the Sonnitus and wrote to them.  They answered me and said they are only in California till middle of the year and I know the technology is not as good as the BAHA but I am wondering what it would be like to have this metal piece in the back of my ear for the rest of my life.   How would it feel?

Mei Mei
Title: Re: I want a Baha. NOW!
Post by: saralynn143 on February 23, 2010, 11:06:21 am
Sara, I'm on a student plan with Aetna that specifically list "implants" as covered. 

Wow, all kinds? That's a generous policy.

(Yes, I am being facetious.)

Sara
Title: Re: I want a Baha. NOW!
Post by: leapyrtwins on February 23, 2010, 12:18:16 pm
I am wondering what it would be like to have this metal piece in the back of my ear for the rest of my life.   How would it feel?

Actually the BAHA abutment isn't in the back of the ear.  It's in the skull behind the ear and you don't really notice it on a day to day basis.  It becomes a part of you - kind of like wearing contact lenses.  They help you see, but you don't really think about them being physically in your eye.

I've had my abutment for 2 years next week and unless I happen to hit it with my comb I generally don't give it a second thought.

A BAHA isn't for everyone, but personally I chose it because I didn't want to wear something in or behind my ear - like a TransEar or a conventional hearing aid.  I can't imagine the Sound Byte because then I'd have something in my mouth as well as behind my ear.  I know that others are very open to this, but it's just not for me.  Likewise I'm sure a piece of titanium implanted into the skull isn't for everyone.  It's a lot like AN treatment.  You need to decide what is best for YOU.

Jan

Title: Re: I want a Baha. NOW!
Post by: lawmama on February 23, 2010, 12:55:56 pm
Sara, I'm on a student plan with Aetna that specifically list "implants" as covered. 

Wow, all kinds? That's a generous policy.

(Yes, I am being facetious.)

Sara

I should not have put that in quotes, it wasn't accurate.  Actually, they cover "Durable Medical Equipment Expense."  Which is what I think this would fall under...maybe?  I think the quoted area below is going to be the catchy area.  They might try to say this is for my convenience and not medically necessary.  Hopefully they won't. . .

In determining if a service or supply is appropriate under the circumstances; Aetna will take into consideration:

Information relating to the affected person's health status;

Reports in peer reviewed medical literature;

Reports and guidelines published by nationally recognized health care organizations that include supporting scientific data;

Generally recognized professional standards of safety and effectiveness in the United States for diagnosis, care, or treatment;

The opinion of health professionals in the generally recognized health specialty involved; and

Any other relevant information brought to Aetna's attention.

In no event will the following services or supplies be considered to be Medically Necessary:

Those that do not require the technical skills of a medical, mental health, or dental professional; or

Those furnished mainly for: the personal comfort, or convenience, of the person, any person who cares for him or her, or any person who is part of his or her family, any health care provider, or health care facility; or

Those furnished solely because the person is an inpatient on any day on which the person's Sickness or Injury could safely and adequately be diagnosed or treated while not confined; or

Those furnished solely because of the setting if the service or supply could safely and adequately be furnished, in a Physician's or a dentist's office, or other less costly setting.
Title: Re: I want a Baha. NOW!
Post by: JerseyGirl2 on February 23, 2010, 03:14:20 pm
I am wondering what it would be like to have this metal piece in the back of my ear for the rest of my life.   How would it feel?

I completely agree with Jan's assessment. I've been calling my BAHA my "third contact lens" for quite some time now. Mind you, this didn't happen overnight -- I thought my head would be permanently numb and that I'd never be able to sleep on the abutment side of my head ever again, but the numbness went away over the course of many months and I now roll over to that side of my head without giving it a second thought.

Catherine (JerseyGirl 2)
Title: Re: I want a Baha. NOW!
Post by: Mei Mei on February 23, 2010, 03:32:38 pm
Thanks Jan and Catherine,
I really wanted your input.  After the numbness that I'm having from the January surgery and now they are mentioning another surgery for June, I'm just about burned out but will probably do this.  I tried the Intenso and the doctor whispered into my ear and I could actually hear him whispering to me!!!  After the 0% on the audiogram, this was incredible.    Thanks again for your input!
Mei Mei
Title: Re: I want a Baha. NOW!
Post by: Pooter on February 23, 2010, 05:00:24 pm
my abutment is located in the "dent" in my skull from my AN surgery. 

Jan

Okay, color me confused..  If it's in the 'dent', then what is it attached to?  I have always been under the impression that my 'dent' is a hole in the skull...  Doesn't the implant get drilled into the skull bone?  If the 'dent' is a hole, then to what is the implant attached drilled into?

Thanks,
Brian
Title: Re: I want a Baha. NOW!
Post by: Denise S on February 23, 2010, 05:28:43 pm
Lyn,
Hopefully your office will bill it like a prosthetic vs. and aid.   I read that somewhere on the Cochlear Amercia webiste, plus the audiologist at MEI said that is how they treat it (just like if you lose an arm.....you can get a prosthetic that can be put on or of to help with your limitation.   Well, you lose you're hearing {one of our main senses} should be in the similar catergory).

You've probably been on the site, but Cochlear America even has the post on how to help get insurance to cover a BAHA if it has been denied.

Title: Re: I want a Baha. NOW!
Post by: leapyrtwins on February 23, 2010, 05:49:11 pm
Mei Mei -

one of the nice things about having BAHA surgery after AN surgery was that my skull was still numb.  When the doc shot the lidocaine into my head I had to actually ask him if that was what he had just done.  I could feel a pinch or two, but that was all.  See, they are good things about AN surgery  :D

Lyn and Denise -

I posted the insurance info from the Cochlear Community on this Forum http://anausa.org/forum/index.php?topic=11751.msg135380#msg135380  The Community is full of great information and interesting people; I joined it a few weeks ago.

The BAHA is an implant or prothesis, which is what distinguishes it from a conventional hearing aid and which is usually what gets the insurance companies to cover it.

Pooter -

now you've got me feeling my head LOL  The abutment does indeed get drilled into your skull and my dent isn't an empty hole, it's just a depressed area from my AN surgery.  It's even more depressed now due to the BAHA; the abutment when implanted sinks somewhat and leaves a kind of "divot".

I know my abutment is in the same area of my AN surgery because my doc talked about the screws from my surgery interferring a little bit.  He said the screw that might pop through my skin is one of the ones he used to screw my bones together during the AN surgery. 

I had lots of hardware (titanium mesh, titanium plate, titanium screws) during my AN surgery, plus belly fat - and my "window" of skull was put back so it could fuse into my skull again.  I think this is why I was told my head would have to heal for a few months post op before getting a BAHA.

Some docs place the abutment further back on the skull if there is a need to do so.  I may have mentioned it before; Lori's abutment is a lot farther back on her head than mine is.  She showed it to me @ the symposium.  I remember her saying that there wasn't enough "bone" to put it in the place where mine is.  I think she's somewhat unique in this though.

Perhaps her doc didn't want it to interfere with her halo  - which obviously isn't an issue for me LOL

Jan   

Title: Re: I want a Baha. NOW!
Post by: Mei Mei on February 24, 2010, 07:52:27 am
Dear Jan,
Thanks once again for the really thorough explanation.  Until now I didn't know I had screws in my head as well as Titanium.  I've always joked before about loose screws!!!   Can you tell me what you meant about belly fat?

Mei Mei
Title: Re: I want a Baha. NOW!
Post by: lawmama on February 24, 2010, 08:16:08 am
Sara, I'm on a student plan with Aetna that specifically list "implants" as covered. 

Wow, all kinds? That's a generous policy.

(Yes, I am being facetious.)

Sara

As I was drifting off to sleep last night, I finally got this joke.  Good one!!!   :D  (Did they remove my sense of humor during my surgery?  LOL)


Lyn
Title: Re: I want a Baha. NOW!
Post by: ppearl214 on February 24, 2010, 08:32:22 am
Sara, I'm on a student plan with Aetna that specifically list "implants" as covered. 

Wow, all kinds? That's a generous policy.

(Yes, I am being facetious.)

Sara

As I was drifting off to sleep last night, I finally got this joke.  Good one!!!   :D  (Did they remove my sense of humor during my surgery?  LOL)


Lyn
t'is ok Lyn... also had my humor removed when my head was zapped. :)

back on topic folks! :) Thanks!
Phyl
Title: Re: I want a Baha. NOW!
Post by: leapyrtwins on February 24, 2010, 08:40:58 am
Mei Mei -

some docs, mine included, do an abdomenal fat graft at the same time as the AN surgery.  They use this fat to "plug up" the hole in the head where the tumor resided.

I'm not sure of the theory behind this, but I thought at one point someone on the Forum said it was to prevent CSF leaks.  However, I'm not sure that's the reason, as some here have had fat grafts and still had CSF leaks (I didn't).

My docs do the fat graft from the left side of the abdomen so that in future years it's not confused with an appendectomy scar - in case a patient is incapacitated and can't communicate with medical personnel.  My scar is slightly to the the left and a few inches below my belly button. 

And no, they didn't take enough belly fat in my opinion.  I wish they had taken several pounds of it  :D

I didn't lose my sense of humor during AN surgery  ;)

Jan
Title: Re: I want a Baha. NOW!
Post by: Mei Mei on February 24, 2010, 11:41:25 am
Had I known about this ahead of time I would of asked for a Tummy Tuck at the same time.....Ha Ha!!!
Mei Mei
Title: Re: I want a Baha. NOW!
Post by: lawmama on February 24, 2010, 04:48:13 pm
Had I known about this ahead of time I would of asked for a Tummy Tuck at the same time.....Ha Ha!!!
Mei Mei

I literally did ask for this.  I said, "Hey!  I'll already be under, how about doing a tummy tuck while you're at it?"  They said, "Uhhhh....no."   :P

Lyn
Title: Re: I want a Baha. NOW!
Post by: Denise S on February 24, 2010, 08:05:39 pm
I've been getting good feedback from Cochlear America via e-mail.  PLUS today I got a package from Fedex and it came with a CD too (didn't watch it yet).    It also included the phone number and some info. for getting insurance to help pay.   

(have to say I also got all answers from TranEar that I asked them via email and got stuff from them last week too).
Title: Re: I want a Baha. NOW!
Post by: leapyrtwins on February 24, 2010, 10:07:47 pm
Pooter -

update on abutment placement.

Check out this post by Lori http://anausa.org/forum/index.php?topic=11939.0

It's the one where she says I'm correct - wish she would have typed that in all caps  ;) ;D

Jan
Title: Re: I want a Baha. NOW!
Post by: Pooter on February 25, 2010, 01:26:38 pm
Jan,

Jan,

So, just to clarify for my feeble little brain.. If the skull piece that was removed during your AN surgery was replaced, then they can put your abutment into that part of the skull.  If it was not, then they have to find another place and likely it would be further back on your head?  If that's not true, then where have I gone wrong?

I don't think mine was replaced (granted, I don't know for sure)..  I'd almost rather it be higher up than further back if I ever get one implanted..

Denise, I got a package from Cochlear also..  I haven't watched the DVD yet either.. (Just came yesterday)

Regards,
Brian
Title: Re: I want a Baha. NOW!
Post by: leapyrtwins on February 26, 2010, 08:09:25 am
Pooter -

don't knock your brain; it's been through surgery, you know  ;)

You are understanding this correctly.  Basically the abutment needs to be placed in "good bone" - as Lori describes it.

Your doctor will be able to give you a better idea of what that means to you.  I appparently have "good bone" in the area of my AN surgery, so that's where my abutment is.  Others might not have "good bone" in that area, so the abutment is placed above or behind that area. 

The main idea here is to make sure the abutment is put in an area that it will stay in once the skull has calcified.  If the area is "bad" the abutment may become loose or even fall out (although this is pretty rare).

Jan
Title: Re: I want a Baha. NOW!
Post by: Denise S on March 24, 2010, 05:36:44 pm
UGH!!!!   O.K. Brian.........where's the rich uncle??  hahaha

I got a call from Michigan Ear Institute and they said Cochlears OMS helped them with trying to get BAHA covered by my insurance.   The rep for my insurance said a straight up NO because my stuff says: No hearing aids and no surgically implanted hearing aids.    Not what I needed Monday on an already depressing day.  Supposedly the rep also told MEI there is no appeals, no nothing because it is black & white in my policy.

WELL, of course I don't just sit back.   I called the Cochlear OMS rep and asked a few questions (she was AWESOME).   She said the only possibility is if our insurance may be self funded and someone would be able to take a bunch of info to the decision board and try to push it as a Prosthetic.   What the hey, I called my husbands human resource dept. (in Texas, we're in Michigan) and I got the Secretary who actually knew I had gone through the surgery, etc. etc.     She said right away "Denise, we are self funded to a certain amount and if you can get me documents from Cochlear as to procedure, why they treat it more as prosthetic vs. hearing aid, and the cost amounts, a letter of necessity from the doctor, and a letter from me stating why I think I need it"   SHE personally will take it to the board for me and try her best.   Sometimes it works, but she has never came across this situation.   Her own comments were : "you guys are a young family and have kids and losing 1/2 your hearing has to be devastating"       

Oh MY......I wish I could have reached through the phone to hug her!!!    So I made the calls to get all the info. soon and send it to her and say more prayers.    If she can't do it, then for sure I'm done.       SO......don't just give up is my comment for others.      Of course I will post on the Cochlear Community too.    Still have no clue and not getting my hopes to high, but all I can say is wow!         AND.....Cochlears OMS is GREAT while I dealt with them!    So, wish me luck and say a prayer.......I am HATING and my family too is struggling with this sudden SSD.

Denise Sanford (MI)
Title: Re: I want a Baha. NOW!
Post by: Mei Mei on March 24, 2010, 06:11:14 pm
Dear Denise,
I admire you for your persistence!   You ROCK!!!

Mei Mei
Title: Re: I want a Baha. NOW!
Post by: ombrerose4 on March 24, 2010, 08:28:42 pm
Hi Denise,

I really hope this works out for you. This SSD is for the birds! I can't even imagine how hard it must be with raising kids, mine are grown and its hard enough. I will be thinking of you. :)
Title: Re: I want a Baha. NOW!
Post by: Kencutus on March 25, 2010, 11:33:58 am
Good luck, Denise!  You Rock!
Title: Re: I want a Baha. NOW!
Post by: Jim Scott on March 25, 2010, 03:00:20 pm
Denise ~

I'm awed by your tenacity and I hope it's amply rewarded with a positive result for your BAHA claim.   Well done!

Jim
Title: Re: I want a Baha. NOW!
Post by: lawmama on March 25, 2010, 03:52:52 pm
Oh goodness, Denise!!  I really, really hope your appeal works.  That is so frustrating.  It almost sounds like they wrote that provision to specifically dis-include Bahas and Cochlear implants, which seems so unfair. 

I called the other day and my whole file has fallen into a lag somewhere between the office where my Baha test was done and the billing office, so they haven't even sent it to my insurance for approval yet.  I'm hoping they'll get that done soon.

Lyn
Title: Re: I want a Baha. NOW!
Post by: leapyrtwins on March 25, 2010, 08:24:54 pm
Denise - and Lynn -

persistence generally pays off in requests for BAHA coverage.  For some reason, first requests for coverage are often denied, but subsequent requests are usually honored.

I guess insurance companies figure patients will just give up and call it a day.  Apparently they have no clue who they are dealing with  ;D

Stay tough and hang in there,

Jan

Title: Re: I want a Baha. NOW!
Post by: Denise S on March 27, 2010, 07:10:33 am
Lyn     Mine actually isn't an appeal.   Basically was told flat out NO because of what is in our contract.   The only way I could even get a written denial is if I were to HAVE the surgery, then the charges would come back denied.   I don't want to take that risk....can't afford it AT ALL.

But, I for some reason just thought I would call that OMS # that came in the folder of information and spoke with the lady who did my 'case'.  She said there is usually NO way to get around it "unless" my insurance may be self funded, then I can try through human resources.   What the heck, I took a shot and made a call.    I think the thing that is helping me out so far is that our insurance IS "partially" self funded.   Then, the HR Secretary (whom I never met and lives many states away) has sympathized for my young family since originally hearing of my tumors and surgery for the AN.  When she heard my explanation of the SSD, she sounded like she was in tears and vowed to do whatever she could for me.   So, I refer to her like my little angel....she is my advocate right now.      OF COURSE.....still no guarantee, but I have to try!!!!!

If it fails, there is one doctor more local who wants to start doing BAHA and has done none yet, so I thought 'maybe' he would work something out if I was his guinea pig  :)    (can you tell I really need one.........more like I feel like I need one...........SSD & tinnitus just suck for me & my family so far)

I am crossing my fingers, but in the mean time I found out I have another condition that may take precedence over the BAHA.   Chiari Malformation and something else, but don't see neurosurgeon to know more until the 14th....ugh, more waiting.

thanks,
Denise