Author Topic: Insurance - BAHA claim - Humana  (Read 456 times)

shrsand

  • New Member
  • *
  • Posts: 4
Insurance - BAHA claim - Humana
« 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.

bfoley

  • New Member
  • *
  • Posts: 49
Re: Insurance - BAHA claim - Humana
« Reply #1 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!

alabamajane

  • Hero Member
  • *****
  • Posts: 609
Re: Insurance - BAHA claim - Humana
« Reply #2 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
translab Oct 27, 2011
facial nerve graft Oct 31,2011, eyelid weight removed Oct 2013, eye closes well

BAHA surgery Oct. 2014, activated Dec. 26

 


anything