Success Insurance Appeal for HBOT for hearing loss
My insurance comapany denied my son's hyperbaric oxygen treatment (HBOT) for sudden hearing loss. The insurance company stated that "your child must have sudden hearing loss of at least 70 decibels. your child must have tried and failed glucocorticoid treatment" to receive HBOT. Most insurance only requires 30 decibels loss, not 70.
My son had severe sudden hearing loss. He had intratympanic steroid injection on day 5 and started oral steroid on day 6. He started hyperbaric oxygen treatment on day 8. The firstaudiogram on day 12 shows a significant improvement. Because now he has improved, he doesn't meet the criteria of 70 decibels. However, we really don't know which treatment worked. His ENT told me that he did not know if steroids would work. Thanks to this forum, I found out about the HBOT. His ENT was convinced and referred us to go to a medical center. It is very likely the combination of the treatments that result in a positive outcome.
Because of the insurance denial, the medical center advised stop the treatment for my son. My son had 12 treatments so far. The plan is to have him do 20 treatments. I think it is too cruel to stop the treatments now.
I had filed an appeal to my insurance company. I am going to file an appeal to the California Department of Managed Health Care. Because this will be my last resort, I would like to know if other people have a success story. How do you dispute the denial? Thank you so much.
submitted by /u/lovedebeauvoir
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