I’m 24F and since I was 17 I’ve had issues with sudden onsets of tachycardia coupled with collapsing, loss of vision, shortness of breath, etc. Over the years I’ve seen cardiologists and have ended up in the ER multiple times for this issue. I also have a number of heart issues running in my family, creating more concern about these odd symptoms. Lately I’ve seen an electrophysiologist who wants to get me set up with an implantable loop recorder since the episodes are not regular enough to catch with other methods (such as external monitors as they tend to only be for about 2 weeks). The doctor’s office called insurance twice, both times getting the response that there was no pre-auth needed.
So I’ve been spending the last several weeks getting everything set for the surgical implant, and today I got a call from the doctor’s office today saying the insurance is now saying that they will not cover the implant or surgery. The office said that when they asked for clarification it was said that I was denied based on my age being too young. When I asked the office if there was anything that could be done in terms of getting the insurance to cover the procedure the office said they often have issues getting insurance to cover this procedure and seemed like they just wanted to go “oh well” and told me they’re planning to cancel it.
Is there anything I can do to appeal the denial, especially since the reasoning given was that I am too young despite the fact I’ve gotten other procedures in the future to avoid this but none of them yielded a diagnosis?
submitted by /u/lmat04
[link] [comments]I’m 24F and since I was 17 I’ve had issues with sudden onsets of tachycardia coupled with collapsing, loss of vision, shortness of breath, etc. Over the years I’ve seen cardiologists and have ended up in the ER multiple times for this issue. I also have a number of heart issues running in my family, creating more concern about these odd symptoms. Lately I’ve seen an electrophysiologist who wants to get me set up with an implantable loop recorder since the episodes are not regular enough to catch with other methods (such as external monitors as they tend to only be for about 2 weeks). The doctor’s office called insurance twice, both times getting the response that there was no pre-auth needed. So I’ve been spending the last several weeks getting everything set for the surgical implant, and today I got a call from the doctor’s office today saying the insurance is now saying that they will not cover the implant or surgery. The office said that when they asked for clarification it was said that I was denied based on my age being too young. When I asked the office if there was anything that could be done in terms of getting the insurance to cover the procedure the office said they often have issues getting insurance to cover this procedure and seemed like they just wanted to go “oh well” and told me they’re planning to cancel it. Is there anything I can do to appeal the denial, especially since the reasoning given was that I am too young despite the fact I’ve gotten other procedures in the future to avoid this but none of them yielded a diagnosis? submitted by /u/lmat04 [link] [comments]Read Morer/HealthInsurance