Surgery next --- now the insurance game

Discuss here about Medical Disability claims and Insurance possibilities for PN treatment options
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Quilter 2
Posts: 163
Joined: Fri Sep 17, 2010 6:24 pm
Location: North East TN

Re: Surgery next --- now the insurance game

Post by Quilter 2 »

A's Mommy;
Forgot something. What did you have to write to get the ins to pay for the Botox? I'm still working on the appeals and getting nowhere. I have United Health Care. The name is a joke.
Thanks for the help;
Doreen
Five pudendal nerve infiltrations with good results.
Sixth Injection left me with more burning, more pain, pain in buttocks.
Botox shot didn't notice any difference
Physical Therapy - Aquatic and Myofascial
External and Internal Manual Therapy on the obturator muscle.
3T MRI with Dr. Potter
2nd opinion with Dr. Hibner in Phoenix
Loretta Robertson PT Phoenix
Decompression surgery Nov. 1, 2011
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Celeste
Posts: 574
Joined: Sat Sep 18, 2010 2:24 am
Location: central Ohio

Re: Surgery next --- now the insurance game

Post by Celeste »

Quilter 2 wrote:Hello to all;
Since I'm going to be needing this info in the near future, I need to understand what all these abbrevaions mean. Please tell me what PLP, FWIW and BTW means.
Sorry for my computer ignorance;
Doreen
Primary Care Provider
For What Its Worth
By The Way
PNE as a result of childbirth, 2002. Treatment by the Houston team, with neurosurgery by Dr. Ansell in 2004. My left side ST and SS ligaments were found to be grown together, encasing the pudendal nerve.

I am cured. I hope you will be, too.

There are no medical answers on the forum. Your only hope is to go to a doctor. I was very happy with the Houston team, which has treated the most PNE patients (well over 400), more than any other US provider.

http://www.tipna.org
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A's Mommy
Posts: 447
Joined: Fri Sep 17, 2010 12:46 pm
Location: Pennsylvania
Contact:

Re: Surgery next --- now the insurance game

Post by A's Mommy »

Doreen,

I had to write a letter of medical necessity (I did this and then my PCP's office put their name to it... since most docs truly do not know what PNE is) stating all the conservative treatments I have tried thus far... including all the doctors I saw, all the drugs I'd taken, and all the therapies/blocks/procedures that I'd had. I also sent in all pertinent dictated reports from all the physicians that I'd seen (this took a while, as I was calling them myself because I wanted it to get done faster).

Any other questions you might have, please PM me. Which approach will you be heading for--- TIR OR TG?

I hope you are having a low pain or pain free day! :D


Sincerely,

A's Mommy
Daughter grew completely on left side of pelvis
Multiple uterine surgeries to fix uterine adhesions, septum, and endo
Had all the conservative workups done, 3Tesla (Potter), recovering from L sided TG (Hibner) 11/10, Botox 6/11 failed, bilateral anterior PNE decompression (distal Alcock's/perineal branch), Aszmann, Vienna, 10/11; dx'd with CRPS Type 2, 12/11, Ketamine @ CCF 2/12, doing 75% better PRAISE JESUS!
http://fighting-pne.blogspot.com
http://www.thepelvicmessenger.org
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