Insurance just denied request for MVD surgery!

After waiting patiently for 3 weeks to get an answer for me to have MVD surgery, I was denied. They said the surgery is unproven and experimental. Has anybody else had this problem? Is there any documentation that you have used to get this approved by your insurance? I am open to all suggestions at this point! I have had my life on hold for too long, and need this resolved.

Hi Amy,

I’m really sorry to hear that your claim’s been denied, it’s a nightmare of a system to work around. I’m not sure if this is going to be any help, but I’ve been in touch with a neurosurgeon in Bristol who was involved with a long term study of this. I don’t have a scanner so I can’t post it in full, but I can post the abstract and if you think that it may be something that would be helpful, I am certain that he would send you out a copy to submit as evidence for your case.

SRI R KANDAN, SADAQUATE KHAN , DEVA D JEYARETNA, SAMDEN LHATOO, NIKUNJ K PATEL AND HUGH B COAKHAM.

Abstract

This study describes our experience in the surgical treatment of neuralgia of the glossopharyngeal and vagal nerves. Over the last 19 years, 21 patients underwent surgery. Their case notes were reviewed to obtain demographic information, clinical presentation, surgical findings and early results. All patients were the n contacted by telephone for the long term results and complications. Independent analysis of results was carried out by a neurology team. Ten patients had microvascular decompression (MVD). Four patients had MCD and nerve section. In the remaining seven patients, the glossopharyngeal and first two rootlets of the vaga l nerve were sectioned. Nineteen (90%) of 21 patients experienced complete relief of pain immediately after surger y. The remaining patients reported an improvement in their symptoms. There were no mortalities. Fo ur patient s experienced short term complications, which resolved. Two patients were left with a persistent ho arse voice. At follow up ( mean duration of 4 years) there was no recurrence in stymptoms. In our experience surgery is safe and effective for the treatment of vago glossopharyngeal neuralgia.

I don't know if it's of any help but it was the department of neurosurgery, frenchay hospital bristol that conducted the study.

I know it's certainly the largest that was done in the UK, possibly THE largest, as they were treating international patients due to the fact that it's such a rare condition people travel to those with the experience. I hope you find this of some help

Much love

Gracie x x x


Grace,
Sorry it has taken so long for me to respond. Life has been extremely chaotic! My surgeon was able to talk to my insurance company, and get the surgery approved! I am scheduled to have the surgery on April 13th at UCSD. While I am glad to be finally getting the surgery, I am starting to get nervous…

Thanks for your response!
Amy

Grace Mackay said:

Hi Amy,

I’m really sorry to hear that your claim’s been denied, it’s a nightmare of a system to work around. I’m not sure if this is going to be any help, but I’ve been in touch with a neurosurgeon in Bristol who was involved with a long term study of this. I don’t have a scanner so I can’t post it in full, but I can post the abstract and if you think that it may be something that would be helpful, I am certain that he would send you out a copy to submit as evidence for your case.

SRI R KANDAN, SADAQUATE KHAN , DEVA D JEYARETNA, SAMDEN LHATOO, NIKUNJ K PATEL AND HUGH B COAKHAM.

Abstract

This study describes our experience in the surgical treatment of neuralgia of the glossopharyngeal and vagal nerves. Over the last 19 years, 21 patients underwent surgery. Their case notes were reviewed to obtain demographic information, clinical presentation, surgical findings and early results. All patients were the n contacted by telephone for the long term results and complications. Independent analysis of results was carried out by a neurology team. Ten patients had microvascular decompression (MVD). Four patients had MCD and nerve section. In the remaining seven patients, the glossopharyngeal and first two rootlets of the vaga l nerve were sectioned. Nineteen (90%) of 21 patients experienced complete relief of pain immediately after surger y. The remaining patients reported an improvement in their symptoms. There were no mortalities. Fo ur patient s experienced short term complications, which resolved. Two patients were left with a persistent ho arse voice. At follow up ( mean duration of 4 years) there was no recurrence in stymptoms. In our experience surgery is safe and effective for the treatment of vago glossopharyngeal neuralgia.

I don’t know if it’s of any help but it was the department of neurosurgery, frenchay hospital bristol that conducted the study.

I know it’s certainly the largest that was done in the UK, possibly THE largest, as they were treating international patients due to the fact that it’s such a rare condition people travel to those with the experience. I hope you find this of some help

Much love

Gracie x x x


I'm delighted you got approved!!! :) please keep us posted as to how everything goes, I can understand the nerves, but I'm sure it'll all be worth it in the end.

Love

Gracie x x x

Thank you Gracie! I will keep everyone posted!

Hi Amy, My name is Marilyn and I'm brand new to this site. I've been following your comments and I'd like to congratulate you on geting approval for your surgery.

the last post I see is dated 3/26 - have you had the surgery and tell me how it went and what side effects you have ----- we're contemplating the surgery but a little worried...... mARILYN

I am supposed to have MVD surgery for GN next month. I have been going thru this pain for years. It wasn't too bad in the beginning but got worse to the point I got syncope with it and harmed myself needing surgery! This will be my 5 trip to the Mayo and I have put it in the hands of the Lord. I just can't go on like this. I pray the insurace will pay even tho I have to pay 20% of all my medical bills which has added up believe me. Has your Dr. written to the insurance co. or spoken with them? Just remember, everything happens for a reason. Just keep trying. Good luck and God bless. JB

Hi Amy,

Who is your Insurer and what kind of policy do you have?(HMO, PPO EPO) I worked for BC & BS in Appeals before I became ill. Maybe I can help you.

Tracy Z.

I has MVD in 2004 for GN. I was so happy when I woke up without Ear Stabbing pain. I did have some side effects but didn't care I was out of pain !!!!

■■■■■■■■■■■■■■■■■■■■■ said:

I am supposed to have MVD surgery for GN next month. I have been going thru this pain for years. It wasn't too bad in the beginning but got worse to the point I got syncope with it and harmed myself needing surgery! This will be my 5 trip to the Mayo and I have put it in the hands of the Lord. I just can't go on like this. I pray the insurace will pay even tho I have to pay 20% of all my medical bills which has added up believe me. Has your Dr. written to the insurance co. or spoken with them? Just remember, everything happens for a reason. Just keep trying. Good luck and God bless. JB