ANA Discussion Forum

General Category => Insurance => Topic started by: shrsand on February 11, 2021, 09:57:02 am

Title: Insurance - BAHA claim - Humana
Post by: shrsand on February 11, 2021, 09:57:02 am

We were told that my insurance covers everything and we completed our BAHA surgery last year. Now humana denied coverage saying hearing aids not covered under insurance. The total charges shown is somewhere around 60K.

I still have not received Statement Of Benefits yet but was wondering if anyone had faced the same issues and help me navigate which path to take.

Title: Re: Insurance - BAHA claim - Humana
Post by: bfoley on February 11, 2021, 12:25:55 pm

Greetings shrhand!  I am not an expert, but I saw on another post that you need to see how the claim was submitted (what ICD code they used at the Dr. to submit)  The post said you need to be sure they bill with the ICD code for a prosthetic, not a hearing aid.

Wishing you success in getting coverage!

Title: Re: Insurance - BAHA claim - Humana
Post by: alabamajane on February 16, 2021, 08:18:03 am

Hi,
Before I paid anything, I would go to the insurance clerk of doctor or hospital that performed the procedure and make sure they coded it as a prosthetic device. BAHA is not a hearing aid as such.

Insurance usually pays for these I believe,, If coded correctly when submitted.
Good luck

Jane

Title: Re: Insurance - BAHA claim - Humana
Post by: JozeAlban on January 18, 2023, 07:12:00 am

That's terrible!

Title: Re: Insurance - BAHA claim - Humana
Post by: BattMaclaren on January 19, 2023, 06:09:53 am

I'm sorry to hear that you're dealing with issues with your insurance coverage for your BAHA surgery. The charges are quite high and I can understand why you're concerned.
Have you considered reaching out to an insurance broker for help?