Peer-to-peer & appeal denial
Hello. I apologize if this has been asked before. Im new to the group and feeling a bit overwhelmed with my situation. My daughter has epilepsy and goes to UCLA neurology for treatment. She was recently scheduled for VNS implant surgery. At the last moment my insurance denied the procedure. Her neurosurgeon did a peer-to-peer. It was denied. They did an appeal and we waited 60 days. It has been denied. I don’t know what to do next. My daughter has over 50 types of seizures daily, including grand mals. She is in danger of sudden epileptic death. She has constant falls and injuries. She has them in her sleep. I’m scared for her. She’s had them half her life and will have them the rest of her life. This VNS gave her hope to live a more normal life. What is my next step? We feel very defeated. Thank you for reading.
Edit: My daughter is 28 years old. I’m 51. I live in Oregon and she is in California. My insurance is UMR through United Health Care. It’s PPO program. My income is about $60,000 a year.
submitted by /u/Infinite-Sky7343
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