ANA Discussion Forum
General Category => Hearing Issues => Topic started by: terisandler on July 25, 2013, 08:44:12 pm
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Just wondering whether or not anybody has experience using the Ponto when the AN side is not totally deaf. The loss in my AN ear is considered moderate to severe and my last audiogram shows 12% word recognition. I was told the fact there is some hearing in my bad ear means I am not a candidate for BAHA. I am doing pretty well with the BiCROS but still notice some deficiencies and am going to try out a Ponto, but the audiologist still doesn't think it will work. Looking for feedback. Thanks.
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Hi Teri!! Wow, this seems just like a topic just for me to answer. I am probably one of the few people on here that does have serviceable hearing and yet got a BAHA (Ponto). My word discrimination was at 40% yet I was determined a candidate for a BAHA device. If you have any specific questions about it all, please feel free to either post it here (so others can also learn) or shoot me a PM. Glad to meet you!
Jay
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Jay, I was told that the hearing I still have would interfere with the bone conduction hearing. It seems like this has not been your experience. How was trying out the Ponto using the headband or whatever it is they use? We're you able to test it out in a variety of situations? Inquiring minds want to know. Thanks, and it's nice to meet you, too!
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Hey Teri! So I didn't try it out, funny enough. I went on blind faith, so I can't answer your question there. As far as the interference thing? I don't know what it would be like if I was totally deaf in that ear, but I do definitely benefit from it. All I hear out of that side without it is the Charlie Brown speak, you know...the "wah wah wahh, wah wah wahh wah" but when I turn it on, all is much clearer. It's not perfect as your normal hearing but it's much better. So given all that, I am glad I got mine! Hope this helps! Cheers!
Jay
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Sounds as if word recognition isn't an issue for you with the BAHA. I just spent an entire weekend asking everybody to repeat themselves and not understanding what my 3 y/o grandson was saying and I was wearing my BiCROS! The frustrating part for me (aside from waiting to hear the results of my appeal for coverage) is that the first 2 weeks they seemed so much better than now. Of course, the listening situation this weekend was pretty different than my norm, too.
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Yeah, that's one thing I've noticed. When I don't wear the device there are times I can hear better out of the bad ear than other times. But 99.9% of the time I still have to go "Huh?" if someone's talking to me on that side without the device. Even with the device in I have times where it's a little bit harder to understand, but no where near as bad without.
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This morning I was given a Ponto Pro to try out for a week. It seems to be working just fine, but there is some feedback. Hopefully it's due to the fact that tie Ponto is on a headband, not an abutment.
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Yeah, more than likely that's the deal. They can do all sorts of adjustments to minimize feedback but it will sometimes happens, like if your device touches something like a hat or if your head is on a chair...little things like that! :)
Jay
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I want to test the Ponto in a noisy restaurant and a class I attend once a month, and if it works as well as it has been, will talk to my audiologist about getting the authorization process started with Humana.
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Good deal, good luck with that! Let me know how it goes! :)
Jay
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Today I told my audiologist to move forward with obtaining preauthorization (or whatever they do to say it's covered) for the Ponto Pro Power. It worked very well and I liked it better than the BiCROS.
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I was just told by my audiologist's office that insurance is denying authorization for the Ponto also. I am NOT pleased!!! I know Oticon has an insurance dept that was not utilized by the office so I told them I won't accept this unless Oticon tells me they won't appeal. Any suggestions?
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Faxing an appeal of the denial of coverage for the Ponto and BiCROSS to the plan administrator of the company I used to work for. Also found a plan that discounts hearing aids including the CROS. I feel better doin g something proactive!
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Hi Teri, sorry this thread kind of got lost to me, I had to hunt for it so I could see if there were any new any updates...so anything new on the insurance front? You'll hear of multitudes of stories decrying the stingy nature of insurance companies and their sometimes constant misinterpretations of what a BAHA should be classified as. If things don't sound good with your appeal, then yes, try to get a hold of Oticon themselves...but your doctor's people should really be trying to do this for you, and all should be well aware of how these things go. Let us know how it goes!! Good luck!
Jay
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Jay, thanks for asking. I received a denial letter from Humana for the BAHA pointing out multiple reasons for the denial: not medically necessary, no coverage for hearing aids, there are less expensive options (right - hearing aids which they outright refuse to cover), and not the standard for treatment in the medical industry. I am paraphrasing here, not directly quoting the letter.
This denial was apparently only the first level denial and Humana has to review it again then deny it again before my former employer will step in to review. Based on the HR dept response to an email I sent upon receipt of this denial letter, I think the company plan administrator may be reviewing my appeal of Humana's denials for making an exception and covering the BiCROS.
Oticon's insurance dept looked up their code for the Ponto Pro and then checked the Humana policy and said Humana specifically stated that code as being not covered.
In my email yesterday, I made sure to rebut Humana's reasoning point by point but, bottom line, I expect the clause about less expensive treatment options will be my former employer's escape clause. In the meantime, I am qualified for a lower income program that dispenses the Phonak CROS systems with a much lesser grade receiver and I found another HA discount program (not as deep a discount) that I will look into for the upgraded Phonak receiver I tested. All and all a frustrating few months, aggravated by the fact that I currently am not using any hearing assistance...
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Teri, all I can say is ugh! Insurances, a necessary evil and yet so much frustration! All I can say is keep going and going until you have exhausted ALL avenues! Good luck and keep us informed!
Jay