New to Group- 14 year old daughter had AN surgeies in October & November

[CHD63]

Just being a teenager these days is stressful so I can only imagine how all of this has affected Danna.  The worst part is behind her now so that helps, but I'm sure each one of these appointments and changes are very stressful for the two of you.

Thinking about you both this morning and hoping all will goes well with the shower, etc.  Many prayers for you both as Danna goes back to school.

Clarice

[Mark241]

I am so sorry you have traveled on this road Danna. I know your young, but your strength and fortitude is an example to all that have endured the same as you, and for all of those that have yet to be diagnosed, you will inspire and give hope to many. May God bless you and your family.

[lori67]

I know she'll do great and I'm sure it will be good for her to see her friends!  The first day will probably be the hardest, but it will get easier from there!

Have a great day - both of you!

Lori

[wendysig]

Caroline,

You and Danna have been through so much, I can understand how stressed out you are.  Please believe the worst is behind you.  You have both been so strong, I hope you will agree when you look back that this part of your journey was much more simple than the AN surgeries and recovery.  It really does only get better from here on.  Hang in there!

Hugs to both of you,
Wendy

[CarolineO]

Stressed so I  haven't been in for a while. 1/18/11 received call from Doctors office that Danna's BAHA
had been approved- needed to order correct color and schedule surgery.  Went ahead and had surgery....
HOROR.... Received letter saying that surgery had not been approved!  I don't have $50k

Doctor says he has letter stating approved
I have asked for copy of letter.

Should my family be bankrupted?  I am totally stressed.  Danna is finally healing from surgery and is
anxious to have BAHA device on 5/12/11.... what if I cannot pay for it?  Would she have gone through
this surgery and not get the device?  How in the world can I pay for it?

This is a nightmare.

[leapyrtwins]

Take a very deep breath.  I'm confident things will work out.

If the doctor says he has a letter of approval, I'd believe him.  Doctors aren't usually willing to do a BAHA surgery without insurance approval since some insurance companies don't cover them.  I know my doctor's office would not schedule my surgery until my insurance company sent them a letter stating it was covered.

If by some chance there has been a mix-up and there was no approval, I'm sure the doctor's office will be willing to work with you on some type of payment plan.  Chances are also good that they'll discount the cost of the surgery and perhaps even the cost of the processor.  My BAHA implant and first processor cost close to $50,000 but by the time my insurance discounted it, my doc got MUCH less.  I don't know what processor your daughter is supposed to get, but Cochlear let's doctors set the prices for their processors.  And sometimes docs give patients who pay out of pocket their physician's discount (basically forgive the markup they usually get).

Doctors aren't heartless and I'm sure your daughter's doc will know that you agreed to proceed with the surgery with the good faith intention that it would be paid for.  He'll work things out with you if the insurance doesn't ultimately pay the bill.

Have faith,

Jan

[Jim Scott]

Caroline ~

I echo Jan's astute opinion.  I suspect some insurance company claims person made an error.  Believe me, it happens.  My wife used to be a claims supervisor for a major insurance company and 'mistakes were made' - often.  Frankly, if your doctor has a letter from the insurance company approving the procedure it will very likely be paid by the insurance company.  The only possible glitch would be if he or his office staff misunderstood something in the letter or, quite possibly, didn't submit the claim under the proper code (crucial - and a common error).  Not to worry, if that is the case the doctors office can simply re-file his claim under the correct code.  It's possible - but not probable - that the insurance company made an error in approving the BAHA.  I'm not an attorney but I believe that even if they did make that error, as long as they sent the doctor a letter stating that the procedure was approved, they are legally liable to pay for it.  So, no matter the cause of the 'glitch', I seriously doubt you'll be expected to pay for the procedure.  However, 'worst case scenario': the doctor's office, would, as Jan stated, allow you both a discount and a 'time payment' plan.  Rest assured, your daughter is very likely to get her BAHA.  Now, please try to stop worrying.  Because your doctor has an approval letter from the insurance company, I'm sure this is going to work out O.K.   Really.

Jim

[jaylogs]

Hello, I just wanted to chime in and say hello...I can't believe I missed this thread and just now reading about all this!! Wow, what a story and now you are having these insurance issues!! Definitely not cool! Jim and Jan both offer VERY good advice, so try to relax and these knucklehead will realize the error of their ways.  Hang in there and please keep us posted.  We all have some very good shoulders you can lean on!
Jay

[CarolineO]

Sorry to have vented on everyone.  I will follow-up this week and try to take care of things.
Danna needs to know that I don't know all that is going on with her.  I panic as she is now on
Swim team and wants to play soccer.

How do you swim if you don't hear whistle? 
How do you play soccer if y ou head the ball and  you have an implant?

I am afraid that I wil hold her back from all she is reall yable to do.  She is back in several
Honors classes and catching up on all her home work.  I think I might be her biggest handicap!

She is singing and playing guitar again... she sounds great. She'll have to learn that she doesn't
need to sing so loudly.  However, her voice is lovely!  I hope I don't slow her down because she
is totally capable. 

[tenai98]

Wowsers
Like Jaylogs, I just came across this thread.  what a brave young woman Danna is.  I still yet have to read her story and will do so now. Welcome to the forum.
JO

[leapyrtwins]

Caroline -

you don't need to apologize for venting - it's one of the many things we're here for.  So vent away - it's therapeutic 

I don't have answers to your BAHA questions - you might want to pose them to your daughter's doctor.  Another great resource is the Cochlear Community (www.cochlearcommunity.com) - lots of BAHA wearers (including many active teens and young adults) there.

Holding kids back is a fault of many parents - I know I'm guilty of it.  Don't be so hard on yourself. 

Jan

[CarolineO]

Couple of notes:

The device has been covered by insurance- not as expensive as originally thought.  Only 10k
The doctor is working on getting his potion paid but not too concerned.

Next week Danna should have the device attached and tuned. 

Is there ever an Atlanta area get together?  Physcially Danna is healing very well.  She has
struggled a little with feeling isolated.  Had a few rough months.

I think she is doing better but I know she'd love to talk with other people who have been
through the same experience and understand "the feeling". 

[leapyrtwins]

There is information on ANA support groups on the main page of the ANA website - and I believe there is an Atlanta group.

If you can't find info., perhaps PM cindyj.  She might know.

Jan

[cindyj]

There is information on ANA support groups on the main page of the ANA website - and I believe there is an Atlanta group.

If you can't find info., perhaps PM cindyj.  She might know.

Jan

Yes, she does know - she's the support group leader   Caroline, the next meeting is scheduled for Jul 23 at 10:00 - did you ever get on the ANA mailing list?  If so, you should receive a notice about the meeting w/ the particulars.  If not, let me know and I'll send you a PM w/ the info.  Do you still have my phone number?  We had 2 BAHA reps at our last meeting, so would be great if you guys could come to share your experience with the group...a couple of other members had the implant done recently also.  You guys could all "compare notes." 

Hope to see you and Dana there!

Cindy

[leapyrtwins]

Cindy -

didn't realize you were the leader.  My bad 

Jan