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What should/can I do in this situation? I was approved for the DBS procedure by my primary insurance (a large national company), however they denied inpatient status for the 2nd phase surgery. My secondary insurance,Tricare covers DBS when it's for chronic pain, and they have it as an inpatient status, however when they are a secondary they use the guidelines set by the primary. I'd like to see if the working group that creates insurance guidelines would like to undergo surgery for 3+ hours having holes drilled in their head and leads inserted in their brain and then ride 3+ hours back to home? I sorta doubt it! Do I have any options?
I've been approved by my primary insurance for DBS. However, they have denied inpatient status for the second surgery. The first and third surgery is outpatient and there is agreement between Vandy and my primary insurance.They are saying this invention is considered to be an ambulatory procedure and can be performed in an outpatient status! I'm putting up an appeal and I need some help from this wonderful group. I'm just trying to get some data to help my case. How many of you have had the DBS procedure ( drilling holes and lead insertion) in outpatient status? I don't know of a hospital that will entertain doing it in outpatient status. Appreciate your help.