Appeal a Denied Cochlear Implant Surgery
Getting a cochlear implant surgery has its challenges for potential recipients. You must go through a rigorous medical screening and testing process to evaluate you for the surgery. Unfortunately, a cochlear implant can be denied for various insurance reasons. If you decide that this surgery is right for you, learn what you need to do to appeal the decision and get your implant surgery.
Instructions
1. Contact your insurance provider and ask about the details of your insurance coverage. Check what medical procedures are covered and which ones aren't. Research your medical coverage fully to understand the rules and regulations before proceeding with an appeal.
2. Ask for assistance from your company's human resources or health benefits representative and get him involved in your appeals process. Find out how far your company's health plan covers cochlear implant surgery. Document that information and use it in your appeal.
3. Gather any relevant material you can use in your appeal. No document is too small. Ask your insurance carrier for a written denial letter because you need to have the denial reason in order to proceed with your appeal. Have your surgeon and doctor write letters explaining the importance of you getting a cochlear implant.
4. Call a local advocacy group such as the Let Them Hear Foundation to see if the organization can help get your appeal going. Go to the Let Them Hear website and create a user account to register on the website. Fill out online application for assistance. Contact the organization's customer service for any direct assistance you need or to ask what your next step should be.
5. Write a formal appeal letter for your cochlear implant surgery explaining why the surgery would be beneficial to your everyday life. Focus the letter on discrediting the surgery denial reason and not any emotions you have about your situation. Send the letter to your insurance carrier and contact them with the advocacy group to make sure the denial gets appealed.
