Anyone have experience with their insurance company denying their ablation? I would be interested to hear about this from others who have run up against the same situation, and how they responded?
Literally days before my scheduled ablation, my insurance company (Regence) sent me a pre-authorization request in the mail. I immediately notified my EP who was surprised to hear about this given that they had already sent Regence all the necessary medical documents, etc. They again submitted the necessary medical documents on my behalf and a week later, I got a letter denying my request, citing that my drug therapy (I'm on 200 mg of Amiodarone and Pradaxa) was sufficient to handle my AF.
Prior to getting on Amiodarone, I have had infrequent AF episodes over the last 12 years (they began while running). All of them resolved spontaneously with 12-18 hours, except the last one which went on for days and required cardioversion.
My symptoms on Amiodarone involve neuropathy (numbness), excessive heat, and pins and needles in my feet, facial heat (most notable at night), and insomnia (I am only averaging 4-6 hour of sleep a night which is having a big impact on my work).
My added concern is the longterm use of Amiodarone given it's toxicity, especially on the liver. As I also suffer from hemochromatosis, any added toxicity on the liver increases the potential for irreversible liver damage such as cirrhosis.
I am rather amazed that my insurance company will not approve this procedure; on the otherhand, I can also see that this could ostensibly be about not wanting to pay out $16-20,000 for the procedure.
MY EP's NP confided in me that they have previously had trouble getting this procedure approved by this insurance company for some patients, even for those who are far worse off than me.