WHO HAD THEIR INSURANCE PAY FOR TG SURGERY

Discuss here about Medical Disability claims and Insurance possibilities for PN treatment options

WHO HAD THEIR INSURANCE PAY FOR TG SURGERY

Postby openup » Thu Aug 22, 2013 7:56 pm

I am feeling that the Dr should let people know, at the same minute they say let's schedule you for surgery, that there's a possibility your insurance may not pay for this and you should be prepared to come up with the money. Our emotions are already way up and extremely vulnerable and then denial of surgery occurs 7 days prior to the surgery date.

Would like to hear some other stories. How do my fellow TG surgery "Friends" cope?


Thank You,
Openup
PNE dx August 2012
CT guide PN block Sept 2012 moderate relief 8 days, CT repeat Nov 2012 no improvement
U/S guide PN block Jan 2012 no improvement. Continual PT 5 mos. with minimal improvements
PFCN U/S block Jun 2013 no improvement of PNE symptoms.
SURGERY COVERAGE DENIED BY UNITED HEALTHCARE
Laproscopic Pelvic "Lysis of adhesions" to get at scar tissue around PN Nov 2013
PFM dx by Loretta Nov 2012. Continual persistent pain Post Hip Replacement 2008
openup
 
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Re: WHO HAD THEIR INSURANCE PAY FOR TG SURGERY

Postby nyt » Fri Aug 23, 2013 1:10 pm

As you know there are many different plans administered by United Healthcare thus all United Healthcare plans coverage vary greatly. However, I have United Healthcare and they paid for my pudendal surgery. I do not know the rationale for their decision but you can appeal which you should.
2/07 LAVH and TOT 7/07 TOT right side removed 9/07 IL, IH and GN neuropathy 11/07 PN - Dr. Howard
6/08 Obturator neuralgia - Dr. Conway 11/08 Disability, piriformis syndrome - Dr. Howard
4/09 Bilateral obturator decompression surgery, BLL RSD - Dr. Howard
9/10 Removed left side TOT, botox, re-evaluate obturator nerve - Dr. Hibner
2/11 LFCN and saphenous neuralgia - Dr. Dellon 2/11 MRI with Dr. Potter - confirmed entrapment
5/11 Right side TG - Dr. Hibner 2012 Left side TG - Dr. Hibner
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Re: WHO HAD THEIR INSURANCE PAY FOR TG SURGERY

Postby Karyn » Fri Aug 23, 2013 2:46 pm

Hi Open,
My TG surgery was covered 100% by BC/BS via pre-authorization for the procedure. I don't know how Dr. Hibners office works, but for the surgeries I've had (PN and non-PN), a surgery date wasn't scheduled until pre-authorization was received by my insurance carrier.
I'm so very sorry this happened to you. Do you know why United denied your surgery?
Kind regards,
Karyn
Ultra Sound in 03/08 showed severely retroverted, detaching uterus with mulitple fibroids and ovarian cysts.
Pressure and pain in lower abdomen and groin area was unspeakable and devastating.
Total lap hysterectomy in 06/08, but damage was already done.
EMG testing in NH in 04/10 - bilateral PN and Ilioinguals
3T MRI at HSS, NY in 09/10
Bilateral TG surgery with Dr. Conway on 03/29/11. Bilat ilioinguinal & iliohypogastric neurectomy 03/12. TCD surgery 04/14.
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Re: WHO HAD THEIR INSURANCE PAY FOR TG SURGERY

Postby blightcp » Thu Feb 27, 2014 7:32 pm

Both of my surgeries by Dr. Conway were covered by BCBS of IL(corporate insurance).
PT has also been covered.
PN by sedentary job and commute
Treated for IlioInguinal pain 2008-10
PT by Dr. Conway's team | 3 PN blocks @ Elliott in Manchester USA
TIR 2010 and TG by Dr. Conway in May of 2012 uncovered nerve damage, declared surgical failure in May of 2014
PT and bed rest continues
Employer refused accommodations in 8/13, now in the disability war.
Sacrial Stimulator 9/14 by Dr. Ross Boston MA
Anesthetic pain pump trial 3/16/15 by Dr. Ross
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Re: WHO HAD THEIR INSURANCE PAY FOR TG SURGERY

Postby carolynm » Thu May 08, 2014 4:38 am

www.aetna.com/cpb/medical/.../0805.htm...
Policy. Aetna considers pudendal nerve decompression experimental and investigational for the treatment of following ...

I saw this a few months ago. The website is their stance on on surgery and blocks. That's why they aren't paying.
C
PN after using pickaxe doing yardwork 6/11
Potter MRI: Scar tissue abutting L pudendal.
Hibner consult 10/11 w/ plan: 2 mo. PT
No meds work for me
PRF X 3 times in Denver ( was pain free for 5 months after second)
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Re: WHO HAD THEIR INSURANCE PAY FOR TG SURGERY

Postby Positivepoppy » Thu May 08, 2014 4:43 am

I had TG surgery and all consultations, nerve blocks etc paid for by my insurance company in the UK. I realise I'm very fortunate and sorry on top of everything else you are being denied. I hope things can be rectified and you get the treatment you need.
Take care
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Re: treatment in NH

Postby Bets » Tue May 23, 2017 12:58 am

Hi Karen, I saw from your post that you had some initial treatment in NH. I am living in VT (close to DHMC) and would very much like to know who you saw up here. thanks so much
Bets
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Re: WHO HAD THEIR INSURANCE PAY FOR TG SURGERY

Postby Karyn » Tue May 23, 2017 2:34 pm

Hi Bets,

I had my surgeries with Dr. Conway.

Hope this helps!

Kind regards,
Karyn
Ultra Sound in 03/08 showed severely retroverted, detaching uterus with mulitple fibroids and ovarian cysts.
Pressure and pain in lower abdomen and groin area was unspeakable and devastating.
Total lap hysterectomy in 06/08, but damage was already done.
EMG testing in NH in 04/10 - bilateral PN and Ilioinguals
3T MRI at HSS, NY in 09/10
Bilateral TG surgery with Dr. Conway on 03/29/11. Bilat ilioinguinal & iliohypogastric neurectomy 03/12. TCD surgery 04/14.
User avatar
Karyn
 
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Re: WHO HAD THEIR INSURANCE PAY FOR TG SURGERY

Postby Amy01 » Wed May 24, 2017 8:41 am

Insurance coverage may vary, depends upon individual plan. In my case i receive a pre-authorization by my insurance carrier before surgery schedule. Take Care!!
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