Author Topic: newbie  (Read 5962 times)

teffaz

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newbie
« on: March 02, 2009, 08:44:35 pm »
Thank you!
Since being diagnosed one month ago today, I have been scouring this forum and soaking up valuable information like a sponge! Wow! You all are great!!  I can't imagine going through this without you.  The sudden deafness in my left ear lead to an MRI which showed an acoustic neuroma that is 1.1 cm x 5.6 mm.  Of course, I was numb emotionally for several days. After doing research and discussing options with my doctors, I have decided on translab surgery scheduled for April 2.  If my insurance approves, I will also have a BAHA implant at the same time. If my insurance turns me down on the BAHA, I will likely still get the BAHA and pay out of pocket.  I have a couple of questions: (1) Has anyone paid out-of-pocket for a BAHA? (2) Was that during AN surgery, or was your BAHA implant done on an out-patient basis? (3) Has anyone had coverage with their insurance company for the BAHA even though in the insurance company's guidelines it says that it does not cover hearing aids? (For example, the Medicare brochure says that it does not cover hearing aids, but I have heard that Medicare does indeed cover the BAHA. I'm not on Medicare, but I am thinking perhaps the same situation might exist for some private insurers.)
Again, I am very grateful to you for helping this newbie to become informed and reassured!
Teff
1.5 cm. x .5 cm AN
translab May 2009
SSD (before surgery as well as after)
grateful for incredible surgeons: Dr. Porter & Dr. Syms
Barrow Neurological Institute; Phoenix

lori67

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Re: newbie
« Reply #1 on: March 02, 2009, 09:00:10 pm »
Hi Teff and welcome!

Most insurance companies will not pay for hearing aids, BUT...the good news is that a BAHA is actually considered a prosthetic, and therefore, is covered by most plans.  I'm sure not all of them.  It has to be coded properly because as soon as they see the code for hearing aid, they immediately just say "NO".  My audiologist told me that most companies say no initially, but when they send in a letter of documentation stating that you need to have it, they change their minds and cover it.  He's actually gotten to the point that he just sends in the letter with the first request to save time.   

I didn't have to pay out of pocket for mine, but the bill for my surgery and the processor came to over $30,000.   :o  Now, keep in mind I did not have it done at the same time as my translab, so I had to pay for the OR and anesthesia, etc. all over again.  I also chose to have general rather than local, so that added to the price tag.  I'm sure it's more cost effective to have it done at the same time as your AN surgery if that's an option. 

Bottom line, make sure it's not coded as a hearing aid.  The billing person at the doctor's office should know exactly what needs to be done to get it through insurance, and if they say no the first time, stick with it.  Could save you big bucks!

Good luck!
Lori
Right 3cm AN diagnosed 1/2007.  Translab resection 2/20/07 by Dr. David Kaylie and Dr. Karl Hampf at Baptist Hospital in Nashville.  R side deafness, facial nerve paralysis.  Tarsorraphy and tear duct cauterization 5/2007.  BAHA implant 11/8/07. 7-12 nerve jump 9/26/08.

Syl

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Re: newbie
« Reply #2 on: March 02, 2009, 09:32:28 pm »
Hello Teff,

I don't know what I would have done without all these wonderful AN folks either.

I didn't have translab. But, I did originally consider it and having the BAHA surgery all at the same time because my insurance does indeed cover BAHA costs. One of my surgeons then said that he would never do BAHA surgery at the same time as translab again because not everyone ends up liking the BAHA. He recommends that the patient test it out first, once they are SSD. Something to consider.

Syl
1.5cm AN rt side; Retrosig June 16, 2008; preserved facial and hearing nerves;
FINALLY FREE OF CHRONIC HEADACHES 4.5 years post-op!!!!!!!
Drs. Kato, Blumenfeld, and Cheung.

leapyrtwins

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Re: newbie
« Reply #3 on: March 02, 2009, 11:44:10 pm »
Hi, Teff  ;D

I had my BAHA surgery 3/4/08 and my AN surgery 5/31/07.  Some doctors combine the two surgeries, some don't; all depends on the doctor.

BAHAs aren't technically hearing aids - they are implants - which is why some insurance companies cover them.  I was told by someone at the ANA that insurance companies typically deny requests for BAHA coverage the first time you ask, but generally approve them the second time.  I'm not really sure why that is, but the moral of the story is - if your company refuses coverage, don't take no for an answer.  Be persistent!

Having your doc explain what a BAHA is and why you need it will help a lot when you approach your insurance company for coverage.  Most people, insurance personnel included, don't know just what a BAHA is. 

I didn't pay anything out of pocket, but I believe my surgery and processor (Divino) was around $64,000 before my insurance company discounted and paid it.  The processor was only about $4,000.  The balance was for my neurotologist and the hospital.  The hospital was definitely the biggest chunk - cost of nurses, OR, outpatient services, etc.  I didn't have general anesthesia - my neurotologist used local and did the anesthesizing himself - so I saved a little there.

I absolutely love my BAHA and highly recommend it to everyone who is SSD.

Jan

Retrosig 5/31/07 Drs. Battista & Kazan (Hinsdale, Illinois)
Left AN 3.0 cm (1.5 cm @ diagnosis 6 wks prior) SSD. BAHA implant 3/4/08 (Dr. Battista) Divino 6/4/08  BP100 4/2010 BAHA 5 8/2015

I don't actually "make" trouble..just kind of attract it, fine tune it, and apply it in new and exciting ways

suboo73

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Re: newbie
« Reply #4 on: March 03, 2009, 05:15:39 am »
Hi Teff!  I wanted to say WELCOME to the forum (but sorry you have to join the AN club.)
I don't know about BAHA surgery - sorry i can't help you there.
Since i am in W & W (Watch and Wait) mode, i am curious why you chose surgery.
My AN is smaller and i would like to preserve as much hearing as possible, though i know that might not be the result in the end if i have any kind of treatment.

Anyway - This is a WONDERFUL place, you are so right about that! 
I am grateful to all those here who share their thoughts, feelings and give such unending support.

My thoughts and prayers are with you on the AN journey.
Sincerely,
Sue
suboo73
Little sister to Bigsister!
9mm X 6mm X 5mm
Misdiagnosed 12+ years?
Diagnosed Sept. 2008/MRI 4/09/MRI 12/09/MRI 1/21/11
Continued W & W

JerseyGirl2

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Re: newbie
« Reply #5 on: March 03, 2009, 10:58:37 am »
Hi, Teff,

I had my BAHA surgery at the same time as my Translab procedure -- this appears to be a fairly common "combination" where I had my surgery ... but as other posters have commented, many surgeons prefer to perform the BAHA surgery later. I was delighted to have the opportunity -- I was virtuallly SSD prior to surgery and even though I had adjusted well, I wanted to do whatever I could to improve the situation (and the BAHA is a big help!!). While everyone says that the BAHA surgery is not a big deal  -- and I certainly agree with this assessment after reading all the comments -- it was nice not to have to mentally prepare for another procedure on my head a few months following the AN surgery. Best wishes as you proceed through the insurance hoops -- it's worth the time and effort!!!

Catherine (JerseyGirl 2)

Translab surgery and BAHA implant: House Ear Institute, Los Angeles, 1/2008
Drs. J. House, Schwartz, Wilkinson, and Stefan
BAHA Intenso, 6/2008
no facial, balance, or vision problems either before or after surgery ... just hearing loss
Monmouth County, NJ

Keri

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Re: newbie
« Reply #6 on: March 03, 2009, 11:07:09 am »
Hello Teff,

Like others here too, my doctor said he didn't recommend doing the BAHA at the same time as  my translab. Before my translab, I thought I jsut couldn't get the BAHA done soon enough. Now that I'm post surgery (4 1/2 wks), I'm going to wait a bit. Another surgery on my head right now just doens't sound appealing. All the best to you, and I also lived on this site once i heard the words 'acoustic neuroma.' Everyone here is so helpful.

Keep us posted!

Keri
1.5 left side; hearing loss; translab scheduled for 1/29/09 at Univ of MD at Baltimore
My head feels weird!!

anissa

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Re: newbie
« Reply #7 on: March 03, 2009, 11:53:57 am »
Welcome!  I don't much about the BAHA but I hope it all turns out how you want.  I am also new here and my surgery date is the day before yours.  Best wishes!
Anissa
2/11/09 Diagnosed AN 2.1cm
2/26/09 Consult with Dr. Clough Shelton, U of Utah
4/1/09 Translab with Shelton & Couldwell
--little teensy bit of tumor or cells on facial nerve, stuck! No facial weakness, Rt side SSD
4/8/10 1-yr MRI, "Looks great!"

teffaz

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Re: newbie
« Reply #8 on: March 03, 2009, 01:12:39 pm »
To all you wonderful people,

Thank you for your interest and your replies! I will use your insight in guiding my AN path!

To Syl: you mentioned that one of your surgeons recommended that a patient "test out" a BAHA before having one implanted. I am so curious, what did he mean by that? I guess I just don't understand how one can "test out" an implant. Any ideas?

To Suboo73, a watch and wait, who wants to know why I have chosen surgery instead of W & W:  Wow! Good question!

     Here are my top reasons why I am choosing surgery (translab):

     * I have obsessive-compulsive disorder. I know myself well enough to know that I would obsess every day about my AN. How big is it growing? What will it do next to my body?
 
     * I am 59 years old. Longevity runs in my family (my Dad died at 93 years of age). So, I figure I have lots of years left. Why would I want to wait until the AN got a lot bigger and run the risk of not being able to handle surgery? (I have four leaky heart valves: how much worse do they have to get until they pose a surgery risk?)

     * My husband supports my decision! I don't think he could watch and wait any easier than I could! Ha!

     * My deafness came quickly: In August, 2008, my audiogram showed mild hearing loss; in January, 2009, it showed a profound hearing loss (surgeon: "virtually deaf, a non-functioning ear."). I think I could have been tested earlier than January and also found to be dear in my left ear, but I put it off due to being busy with the holidays! So I have strong feelings about anything that caused me to become deaf so quickly! Let's get it out!

On the other hand, one could make a case for watch and wait in my situation. I did consider it! And I totally understand anyone who chooses that route! Surgery does pose risks!

Hope that helps.

Thanks again to all!

Teff



     

1.5 cm. x .5 cm AN
translab May 2009
SSD (before surgery as well as after)
grateful for incredible surgeons: Dr. Porter & Dr. Syms
Barrow Neurological Institute; Phoenix

moe

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Re: newbie
« Reply #9 on: March 03, 2009, 02:37:50 pm »
I had my BAHA placed during the surgery because they knew that I would lose hearing on one side. (Madigan Army Hospital, Tacoma WA). They just nonchalantly said they would put it in at the same time. I thought what the heck go ahead. Didn't work for me though. I have a big bald spot which is covered by hair, and the site became irritated a lot. Plus the severe tinnitus got in the way. I would have preferred to wait and see how I did, thinking back. But I didn't know.If you don't have tinnitus, it is probably ok to have it put in with surgery.  The surgery is so major, I'd say wait and see how you do.
Maureen
06/06-Translab 3x2.5 vascular L AN- MAMC,Tacoma WA
Facial nerve cut,reanastomosed.Tarsorrhaphy
11/06. Gold weight,tarsorrhaphy reversed
01/08- nerve transposition-(12/7) UW Hospital, Seattle
5/13/10 Gracilis flap surgery UW for smile restoration :)
11/10/10 BAHA 2/23/11 brow lift/canthoplasty

Jim Scott

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Re: newbie
« Reply #10 on: March 03, 2009, 03:29:00 pm »
Teff ~

Sorry I missed your 'debut', yesterday.  Please stack my welcome on top of all the others you received and accept my apology for missing your inaugural post.  I don't have a BAHA so I'll let those who do continue to advise you on that issue.  I will wish you a very successful translab surgery next month and of course, a swift and complete recovery.  :)

I've taken the liberty of adding your scheduled surgery to our AN Treatment Calendarhttp://my.calendars.net/an_treatments/d02/04/2009?authenticate=&display=M&style=B.  Please feel free to add details, if you wish.  :)

Jim
4.5 cm AN diagnosed 5/06.  Retrosigmoid surgery 6/06.  Follow-up FSR completed 10/06.  Tumor shrinkage & necrosis noted on last MRI.  Life is good. 

Life is not the way it's supposed to be. It's the way it is.  The way we cope with it is what makes the difference.

Pooter

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Re: newbie
« Reply #11 on: March 03, 2009, 04:24:49 pm »
[...]
To Syl: you mentioned that one of your surgeons recommended that a patient "test out" a BAHA before having one implanted. I am so curious, what did he mean by that? I guess I just don't understand how one can "test out" an implant. Any ideas?
[...]
Teff

My understanding is they have these "magical" wands that allow them to put them on your head where the implant will go and you can "hear" what the implant will do all of the time (when wearing the processor).  They also have wristband type gadgets that do the same thing.. So, you can "test" out the technology without having the implant done..

Btw, have you looked into TransEar?  It's also another popular option for those that are SSD.

Welcome to the forum!

Regards,
Brian
Diagnosed 4/10/08 - 3cm Right AN
12hr retrosig 5/8/08 w/Drs Vrabec and Trask in Houston, Tx
Some facial paralysis post-op but most movement is back, some tinitus.  SSD on right.
Story documented here:  http://briansbrainbooger.blogspot.com/

"I must be having fun all wrong!"  - Roger Creager

Sue

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Re: newbie
« Reply #12 on: March 03, 2009, 06:04:52 pm »
Hi Teff,

Welcome.  My only task here is to suggest that you read this great article on the balance system and how it works.  There is a lot of things that happen to us because our balance system is out of whack.  You may or may not have any of these symptoms, but you might be surprised to find out that you do have some and were not even aware of it.  That was the case with me.  I had some of these things going on long before I knew I had an AN.  Anyway, it's a good article to read, so I encourage you to do so.  :)  Undoubtedly you will have some of these after surgery and it's good to know why you will have the common problem of "wonky head"!


http://www.hearinglosshelp.com/articles/balancesystem.htm

Best of luck to you,

Sue in Vancouver
Sue in Vancouver, USA
 2 cm Left side
Diagnosed 3/13/06 GK 4-18-06
Gamma Knife Center of Oregon
My Blog, where you can read my story.


http://suecollins-blog.blogspot.com/2010/02/hello.html


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suboo73

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Re: newbie
« Reply #13 on: March 04, 2009, 05:58:52 am »
On the other hand, one could make a case for watch and wait in my situation. I did consider it! And I totally understand anyone who chooses that route! Surgery does pose risks!

Hi Teff!  Thank you for explaining why you are choosing surgery.  (It has been difficult, so far, for me to think of anyone operating on my head, but that is just me.)  You sound very confident in your decision - that 'go with your gut' feeling that so many forum members talk about - that is wonderful!

I have to remind myself that W & W and radiation also pose risks.  Some days i want it to be over, have treatment, pretend it all goes away.  However, as i explained to my husband, it never goes away. My hearing is worse, mild tinnitus and one recent bout of vertigo.  So this is my world, the new me and gotta get used to it!

Also - i do think of having treatment before it gets bigger, before i have more symptoms, and before i maybe don't have private insurance.  WOW.

I am so happy for you and your treatment decision!    :)
God bless you on your journey - you inspire me to go on!

My thoughts and prayers for you, your husband and family.

Sue


suboo73
Little sister to Bigsister!
9mm X 6mm X 5mm
Misdiagnosed 12+ years?
Diagnosed Sept. 2008/MRI 4/09/MRI 12/09/MRI 1/21/11
Continued W & W

teffaz

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Re: newbie
« Reply #14 on: March 05, 2009, 02:41:36 pm »
Dear all:

Thank you for your advice and best wishes! It means a great deal to me.

Sue: I appreciate the balance article reference.

Jim: Thanks for the warm welcome and putting me on the AN Treatment Calendar.

Anissa: All the best to you in your April 1 surgery.

Take care,
Teff




1.5 cm. x .5 cm AN
translab May 2009
SSD (before surgery as well as after)
grateful for incredible surgeons: Dr. Porter & Dr. Syms
Barrow Neurological Institute; Phoenix