Playing the Insurance Game

I have talked to my health insurance company four times since yesterday to try to figure out this rechargeable battery issue. I have talked to the audiologist twice (once by email and once in person). First I was told the doctor's office would need to get this all precertified and check a website...this was after I PROVIDED the insurance code for the batteries! After several more phone calls, and being transferred over to the pharmacy department when one of the customer service reps didn't listen very well, I think I know what to do. The audiologist will write a letter of medical necessity  for Elijah to get the batteries. I will fax it to the claims department of the health insurance company. I will then receive a letter stating if the batteries are covered. If they are covered, then I will order the batteries and file a claim...keeping the letter of approval from them in a VERY SAFE PLACE! I have played this game before and had to wait six months to get $600 back from the insurance company, but it is worth it in the end.

Elijah has $300 left before reaching his deductible, but if he goes to the pulmonologist before I order them (he goes on July 14th) then that will put another $200 towards his deductible. His pulmonologist is considered out of network, but we didn't want to switch doctors. My "insurance year" starts on September 1st, so I want to get this all done and ordered before that date! Hopefully, I will get around $400-$500 to go towards the $800 total for four rechargeable batteries!

Visit to the Audiologist

Elijah went in to see the audiologist today for his yearly "check up" If he is not having issues, we go in once a year to just his map and see how things are going. Elijah did well and participated in the mapping session. He has not always been cooperative in the past. However, I did have to promise a "treat" on the way home (edible treat) in order to get him to cooperate. It does drive me a little crazy that I have to bribe a 16 year old.

Even with a bribe in the past, he has been known to complain and still not participate so it was nice to NOT have that happen today. The audiologist showed him his map and played a tone three times and asked him if it was too quiet, too loud or just right. He answered for each one and some of his answers were that it was TOO loud or TOO soft or NOT right, so he was trying. This is really huge for him. He did this for both the comfort level and threshold level for EACH ear. The comfort level is the loudest sound he can hear without it being TOO loud. The threshold level is the quietest sound he can hear, but not so quiet he can't hear it.

$160 for THIS battery rack

While we were there the audiologist checked his processor on his right ear, because it would not connect to the computer. There was some "residue" on the connector part of his processor piece. She cleaned it and got it working. When we put the battery cage back on it, we could not get it to turn back on. After some trouble shooting we determined that the battery cage was defective for some reason. She gave us one to borrow and I came home to order a new one ($160 OUCH). I will mail the other one back to her when our new one comes in. You can see the picture of it on the right.....this is just the rack, I have the cover that goes over it already...OUCH again.

The audiologist also told me that it is better to use rechargeable batteries, because when the air circulates through the disposable battery rack cage (not sure of the official name) it can cause issues with moisture and the processors. This may be why she had to clean the connector piece on his processor. For those who don't know what I am talking about the processor is actually two pieces. The top part is the processor and is the "computer" part of his "ear". The bottom part holds the batteries. These two pieces can be twisted apart, so you have two pieces. When we use the rechargeable batteries, that battery twists onto the processor.

Nucleus 6 processor
 

I called our insurance company and got some information on how to determine if they are covered. The gentleman in customer service was actually very nice and LISTENED. He finally understood what I was talking about and I provided him with an insurance code. They are considered durable medical equipment (DME) and he gave me the info for the doctor's office to get me a letter or assistance with pre-certification. We also have to meet a deductible, but he is actually CLOSE on his personal deductible. This is not my first rodeo, so I will see what I can do. I do prefer the rechargeable batteries to the disposable ones!

Making the Switch to Disposable Batteries

Elijah upgraded to the Nucleus 6 processor back in June 2014. Since that time, he has used the rechargeable batteries that came with his processors. I really like the rechargeable batteries because they last all day and we never have to worry about switching out batteries during the day. He has four batteries and we would switch them out every other day. About a month ago, one of the rechargeable batteries would not take a charge anymore when I put it in the charger. I had already been doing some research and had decided that I would switch him to disposable batteries. Purchasing two rechargeable batteries would cost about $400 and I would have to fight the insurance company to get reimbursed for that. The two rechargeable batteries would last about one year (four batteries lasted about 2 years).

I can purchase 60 batteries on Amazon for $18.25. This would mean I would need on average about 4 boxes of batteries each year for each processor, costing me $146...approximately. The disposable batteries last about 3 days for each processor. This is a lot cheaper than $400 a year. Now, when Elijah swims he has to use the rechargeable batteries if we use the waterproof coil and sleeve to put around the processor. I want to save the rechargeable batteries that are still functioning to use with swimming.

Now, we have used rechargeable batteries in the past, so I made sure to have a few packages of batteries in my purse. However, when we go into the recreation center or the library I usually don't take my purse in. So, there we are in the rec center today when one of the processor's batteries dies. Elijah had to go without hearing in one ear for about an hour. He survived and so did I. As soon as we got home, I made sure to put a package of batteries in my key ring holder!