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Medical Forum / Diseases and Disorders / Prostate BPH / November 2003Insurance denial for Mayo PVP
My insurance company just denied my going to Mayo Clinic for a PVP. They said the procedure was "experimental" in the Minneapolis St Paul area. Clinically, I need a TURP or a PVP. But insurance wants me to under go invasive surgery with higher morbidity, and probable higher expense. huh????? Any help with the arguments for their Appeals Process? Dennis Dennis, I would appeal. PVP isn't experimental. It is medicare approved. There is even a new code for it. There has been over 11,000 PVPs done this year. Patrick > My insurance company just denied my going to Mayo Clinic for a PVP. They > said the procedure was "experimental" in the Minneapolis St Paul area. [quoted text clipped - 6 lines] > > Dennis MY doctors group hasn't done a TURP in 5 months. There is just no comparison. The PVP is not experimental. It is in and out in a day rather than 2 nights in the hospital. The cost difference is amazing. Good luck > Dennis, > I would appeal. PVP isn't experimental. It is medicare approved. There is [quoted text clipped - 11 lines] > > > > Dennis Tell them BUPA the largest Medical Insurer in the UK is only too happy for patients to have PVP because its cheaper and better than TURP etc > Dennis, > I would appeal. PVP isn't experimental. It is medicare approved. There is [quoted text clipped - 11 lines] > > > > Dennis |
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