insurance denial for neurostimulator

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New Member

Date Joined Apr 2012
Total Posts : 3
   Posted 4/27/2012 11:54 AM (GMT -6)   
After 6 lower back surgeries, 6 injections, & therapy, BCBS has declined my doctors request for a neurostimulator.  Has anyone had this problem with their insurance companies?  I am sick of drugs to get through each and every day and Pain..Pain..Pain..  Any advice?

Veteran Member

Date Joined Oct 2008
Total Posts : 2024
   Posted 4/27/2012 12:06 PM (GMT -6)   
hi there
I just wanted to pop in and welcome you aboard to our cp forum.
Glad you found us but sorry you are having so much pain.
There are some members with the stim so i am sure you will hear from them soon.
Hope you will stay here and keep posting on how you are doing.

New Member

Date Joined Apr 2012
Total Posts : 3
   Posted 4/27/2012 12:15 PM (GMT -6)   
Hi Suzane,
Thanks for responding. I look forward to any information I can get. My pain management doctor said he will appeal the BCBS decision. I am wondering if this is a common problem.
How nice it is to know that there is some place I can share with people who understand. Chronic pain makes a person feel so alone at times. My husband says he understands, then in the next sentence moves onto the local basketball scores. I'm sure everyone on this web site knows how that feels.
Thanks very much,

Forum Moderator

Date Joined Feb 2003
Total Posts : 16776
   Posted 4/27/2012 12:43 PM (GMT -6)   
Hi Cotonlover and welcome to the chronic pain forum. I am sorry that you have to be here but glad that you found us. I am sure the drs office was given an explanation as to why they denied the unit and I am wondering what reason was given. Was this to do the trial or was it to implant the unit? Have you contacted your insurance company yourself and and asked why the denial, they will tell you, in fact you have the right to know.

We do understand what you are saying about constantly being on medication. None of us ever wanted to start down that long road, but if it means having some quality life then it is worth it. I do not know how much you have researched the units, but I would not put all of my eggs in one basket thinking this is what will get you off of medications. I have never seen that happen, instead I have seen units not work after being implanted, leads migrating, no being able to get the coverage needed with the unit to the dr refusing to give pain meds because a patient now has a unit and it is not taking car of the pain. If you will use the search feature here at the forum at the top right you will see search, click it and type in SES Units and you should be able to find a great deal of info as we have discussed these at length here at the forum. I would really do a lot of research before agreeing to have a unit implanted.

How long has it been since your last surgery? It could be the insurance is needing more documentation from your drs office too. Please keep us posted on how you are doing and try not to let this stress you out. Take care....Susie
Moderator, Chronic Pain Forum & Psoriasis Forum

New Member

Date Joined Apr 2012
Total Posts : 3
   Posted 4/27/2012 1:20 PM (GMT -6)   
Hi Susie,
I called my insurance company yesterday to find out how they were coming along with our request for a stimulator.  The insurance rep I talked to said they had just denied the request 1 hour prior to my call.  They are sending my Dr. and me a letter with details, so I don't know what they are right now.  I don't know if this is standard procedure to deny the first time or not.  We won't have the temp put in until we are sure the insurance company will cover it, as the temp costs $6500 and the impanted unit $45,000.  We can't cover that cost ourselves.  We have done a lot of research on the units and have 3 friends that have had good success with them.  I feel that I have run out of options, so would like to try it.
Thanks so much for your concern,

Veteran Member

Date Joined Jul 2009
Total Posts : 2042
   Posted 4/27/2012 1:35 PM (GMT -6)   
While some people do have good luck with those units there are quite a few that either have had horrible results or end up only having short term positive results.

I honestly do not know what the real success rates are from them, though many doctors and the manufacturers would like you to believe they are very, very high. In cases like this though the insurance companies probably have a better idea what the real numbers are.

There are many reasons why your insurance may be denying coverage for this procedure. Cost, rate of success, ratio of major problems vs. success, other procedures that they feel should be tried first, lack of information from the doctor, and so on. It could also boil down to the actual policy you have. All insurance providers have several levels of coverage which dictate what they will and will not cover.
2 confirmed herniated lumbar discs. Spinal Arthritis. Spinal Stenosis, diabetic peripheral nueropathy.
Moderator Depression Forum.
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