Question for those who have had a Video EEG

[momof3boys]

Im having mine done in March of this year and I wondered if it was alot to pay out of your pocket for? I am under my husband's insurance. Today I called the Medical center that I will be having it done at, and asked about their financial assistance. The gal said she can send me out some forms for the hospital, but as far as the drs go, those are seperate charges, so I will have to talk to someone in that dept about that. So she gave me the number, I called, and got a voicemail. I left a message and a lady returns my call saying my dr I am seeing doesnt do the Financial assistance in his clinic. So, the gal says to contact my drs office, and ask for the procedure code. I get that from my dr's nurse and call our insurance. They told me by looking at our benifits, we should be covered 100%. They cant give me the exact charges and all... but by looking up the procedure code, they said it looked like I was good to go. But they did say since my dr wants me there for a week, I would have to call my drs and have them fax over a aurthorization form, and pre certification form. I guess when it comes to big in patient procedures, my insurance covers them for 4 days, anything more has to stated in the forms for the reasons why they want me to stay longer.

So I just wondered for those that did have Video EEG's done before, was it alot to pay out of pocket for? My insurance covers my drs charges. So I will have to fill out the forms Im waiting on for the hospital charges to see if I can get help in that area.

[dbrownpilot]

Once my out of pocket deductibles were paid, my insurance covered the rest 100%. However, there are a lot of different procedures for a lot of different policies. You will definitely want to jump through the hoops with your insurance company.

[momof3boys]

Once my out of pocket deductibles were paid, my insurance covered the rest 100%. However, there are a lot of different procedures for a lot of different policies. You will definitely want to jump through the hoops with your insurance company.

Thankfully Ive already met my deductible for this year. The insurance guy said looking at our benifits and policy, it looks to be 100% covered. But to make sure, he said to have the drs office send in those authorization forms so they can get a clear picture of what they are wanting to do. I could have crapped my pants today when I found out the drs office doesnt do the financial assistanting program! :faint:

[Endless]

My insurance paid 100%, since my deductable had already been met by that time last year. Five days in the hospital is expensive - at least my bill was astronomical. I'm hoping your insurance picks up everything.

[momof3boys]

My insurance paid 100%, since my deductable had already been met by that time last year. Five days in the hospital is expensive - at least my bill was astronomical. I'm hoping your insurance picks up everything.

the insurance told me the same thing, i met my detuctable a couple months ago. Looking at it, he said I probably wouldnt have to worry. But since I told him the dr said I was to stay a week, he said to get those forms he requested that way the drs can put the exact reasons for doing this and they can go from there, since its over the 4 days they have covered for this procedure.

[Jan4you]

I know insurance and $$ issues are stressful.

But you did say you met your deductible a few months ago? Right?
Well this is a NEW year and most deductibles start over in January.

Did you know that?

Good luck.. let us know how you are doing

Jan

[momof3boys]

I know insurance and $$ issues are stressful.

But you did say you met your deductible a few months ago? Right?
Well this is a NEW year and most deductibles start over in January.

Did you know that?

Good luck.. let us know how you are doing

Jan

I checked on that too. We get our insurance through my husbands work, and they had to change something last July, so they restarted everything in July of last year. Before that it was November of each year, when we would start all over. Since July of last year, Ive met my deductable. We each (husband and I) have a $200 deductable. So, since mine has already been met, Im good to go there. Im just glad Im having the video EEG done in March, just a few months before we start a new year with our insurance, and Id have my deductable back down to $0 again!

The nurse called me today and told me they always send the forms to the insurance two weeks prior to the procedure being done. If anything would happen to come up, I would get notified. She is such a nice nurse! I swear, with all that Ive been through this year, Im suprised she hasnt got sick of me with all my questions!

[Annette]

Hello:
I had my vidoe EEG in April 2010. There was a lot of preparation for this with regards pre-certification/coverage from the insurance company. This depends on the policy of your insurance company. In my case, my doctor provided pre-certification letters to my insurance company informing them that this procedure is a "medical necessity" for it to be approved. There will be several "sub-procedures" during the video EEG, such as EEG itself, PET scan, psychologcial evaluation. Depending on your seizure activity, my hospitalization stay took 10 days. The approval had taken longer than usual because I found out after 10 days from the insurance company that not all of the "sub-procedures" were covered. The charges involved a huge amount of money which I had assumed were approved prior to the procedure. I had to appeal with the insurance company after the procedure in order for all the "sub procedures" to have maximum coverage. This entailed some follow-up with my doctor to provide a letter of "medical necessity" before my insurance company approved maximum coverage. This is a good (but expensive) procedure to find out other treatment options for my illness. It is better to have treatment options. It is also better to know coverage than none at all. In my case, it was a long, tedious if not stressful time for me to clear out insurance issues. Hope you’re not disappointed. Hope this will not affect your decision to go through the procedure. I would definitely recommend it because it helped me in understanding my illness. Hope this helps. Good luck!

[Endless]

I'm going to add something. Even if the doctor/hospital says it is preapproved, get the procedure codes from your doc, and call the insurance company yourself and make sure that it is. I took the hospital's word for it on one huge bill, and it turns out it WASN'T pre-approved. My insurance company requires pre-approval, and I'm still liable for the whole big bill. I'm negotiating with the hospital now about the charges. I wish I had gotten something in writing from them, or had checked it myself after they said the preapproval had gone through.

Since the video EEG charges are so high, it might be worth this extra step just to make sure.

[momof3boys]

I got the code for the Video EEG from the nurse, which is i believe 95951... I have it written down on the paper in my computer area here. The nurse said to just give that code to our insurance and they will let me know from there..

As far as pre approving anything, the pre certification and pre authorization papers are sent to the insurance company two weeks prior to having this done. The nurse said if anything should happen to come up, like a problem with getting anything approved, their office or the insurance company will contact me to let me know.

In the meantime, I sent back the financial assistance papers for the hospital charges. I have yet to hear back from them, I sent those papers in about a week ago.