Hi guys, I’ve had two appeals for Premera / Blue Cross for T.Nerve Stimulator. I had a Nerve Block at the Drs insistence because the Insurance would not consider paying for the Stimulator without it. It was painful and it made my TN 2 worse. It showed beyond a doubt that the stimulator would work. Then I had a 7 day trial implant with leads and external hardware, it gave me 70% plus relief. We applied for approval for the final permanent surgery and they denied it. We had 1 appeal, they denied it. We had another appeal and they just denied it. For appeal #3, which is my last, they want me to find instances of OTHER insurances that have paid for this procedure. If you know of any, will you please, please send me the info ASAP? The surgeon is moving out of the country so my last chance is next week. The procedures to prove to the insurance that this would work has made my pain go from #4 or 5 with some higher 24/7 to now constant #8 or 9 24/7 without any recourse. My boss talked to me today and asked me if I could get disability-- and I have worked Really really hard at faking feeling great, pain free & carefree, etc. Please if you can help with any of this info, please do!
I hope somebody can help… !
There is a group on FB called Occipital and Peripheral nerve stimulators that may have the info you need. It is a privates group, but if you message the admin she will add you. Once you are added, look at the “files” , there maybe some info there. Also reach out to the members. They were very helpful to me before I got my stim.
Best of luck to you!
http://www.bcbsks.com/CustomerService/Providers/MedicalPolicies/policies/policies/ImplantedPeripheralNerveStimulator_PainControl_2013-03-13.pdf
Here is a link to the medical policy of BC/BS Kansas regarding nerve stimulators I copied from the Occipital and Peripheral nerve stimulator page on FB. Hope it helps!
Christine