Health Organization for Pudendal Education

I am feeling that the Dr should let people know, at the same minute they say let's schedule you for surgery, that there's a possibility your insurance may not pay for this and you should be prepared to come up with the money. Our emotions are already way up and extremely vulnerable and then denial of surgery occurs 7 days prior to the surgery date.

Would like to hear some other stories. How do my fellow TG surgery "Friends" cope?


Thank You,
Openup

As you know there are many different plans administered by United Healthcare thus all United Healthcare plans coverage vary greatly. However, I have United Healthcare and they paid for my pudendal surgery. I do not know the rationale for their decision but you can appeal which you should.

Hi Open,
My TG surgery was covered 100% by BC/BS via pre-authorization for the procedure. I don't know how Dr. Hibners office works, but for the surgeries I've had (PN and non-PN), a surgery date wasn't scheduled until pre-authorization was received by my insurance carrier.
I'm so very sorry this happened to you. Do you know why United denied your surgery?
Kind regards,
Karyn

Both of my surgeries by Dr. Conway were covered by BCBS of IL(corporate insurance).
PT has also been covered.

www.aetna.com/cpb/medical/.../0805.htm...
Policy. Aetna considers pudendal nerve decompression experimental and investigational for the treatment of following ...

I saw this a few months ago. The website is their stance on on surgery and blocks. That's why they aren't paying.
C

I had TG surgery and all consultations, nerve blocks etc paid for by my insurance company in the UK. I realise I'm very fortunate and sorry on top of everything else you are being denied. I hope things can be rectified and you get the treatment you need.
Take care

Hi Karen, I saw from your post that you had some initial treatment in NH. I am living in VT (close to DHMC) and would very much like to know who you saw up here. thanks so much
Bets

Hi Bets,

I had my surgeries with Dr. Conway.

Hope this helps!

Kind regards,
Karyn

Insurance coverage may vary, depends upon individual plan. In my case i receive a pre-authorization by my insurance carrier before surgery schedule. Take Care!!