After years of suffering from headaches, I decided to try occipital nerve stimulation to control my pain. This blog is to document my process to try to help educate others about the process and results.
One of the most common questions I get from readers is regarding insurance and how to get coverage for your stimulator. Mine was easy enough...my doctor's office did all the pre-approval work. But it looks like I jinxed myself by bragging about how lucky I have been to have great insurance to cover my stimulator. Last week I got a letter in the mail from the insurance company saying they were denying over $12,000 worth of claims. I had no idea what they were talking about so I just set it aside. On Tuesday I got a letter from the surgeon's office saying they'd tried submitting my claims several times but the insurance company refuses to pay so it is now my responsibility. Fantastic.
The charges they don't want to pay for are specifically for the stimulator. They already paid everything else, including all the hospital costs, as well as many of the surgical costs. I don't understand how you can pay for 90% of a surgery but not the other 10%. Don't they do hand-in-hand?
I'd like to know why I sat around waiting for pre-approval for 6 weeks when that approval apparently means nothing. On the positive side, I have all the paperwork to back up what I say. On the negative side, I'll have to get a lawyer and go to court to fight this. $12,000 isn't much to an insurance company so I am hoping they will settle out of court but still, it's going to be stressful to deal with.
I guess I should be happy they covered ANY of the surgery, since it seems like so many companies won't. But still...the whole thing is really pretty annoying. I haven't even seen or paid any medical bills in months; I thought this was all resolved. Grr.