Frustrating with my clinic

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dragonman3000

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Hi, my name is Shane and I want to keep it short and simple enough to understand my life story and my frustrating need to get CI. I grew up with hearing aids with all my life and as my hearing loss become deeper and deeper and still retain my ability to speak very well. Right now, I have profound hearing losses in both of my ears with averagely 95 decibels. I used to be Anti-CI but im changed. That because I researched about CI and hearing aids and how it benefit them and me. I realized that even with new powerful aids, I would STILL not able to understand CLEARLY what a person saying. I can hear background and ambit noises very well but I always long for to be able to hear AND understand at the same time. That why Im getting CI and It would be Nucleus 5 however due to recent recall, Im might get Nucleus Freedom. Also, Im getting Phonak Nadia III SP hearings aids this friday too, since my hearing aids(Phonak PowerMaxx 411) is really old(almost 6years) and they are falling apart! Literally! lol!

Anyway, I have a hard time, getting into my hospital for cochlear implant evaluation. The hospital is UCI (UC Irvine Medical Center) I kept calling my clinic(Talbert Medical Group) to make a referral for UCI for cochlear implant. None of the nurses cant get it right! One nurse got it right but it was on May and it have wrong insurance attached to my authorization paper. I have two health insurances, One is HealthNet Insurance and one is Medi-cal. The authorization is suppose to have HealthNet insurance attached to my authorization so UCI can let me in and have an appt for Cochlear implant evaluation. But I called my clinic MANY TIMES. More than 10 times! Only 2 wrong authorizations at different location such as UCLA hospital and other authorizations NEVER made it to UCI. It is frustrating and I wanted to be quick and get implanted soon as possible. I wanted to know if there is any tips or helpful advices. Thank you
 
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Does your clinic have any of the following --

* Patient care dept or supervisor -- this dept exists to make sure patients don't fall through the bureaucratic cracks and have a lot of power in some clinics and hosptitals.
* An administrator for your area of medical care --
in some clinics the budget is king and an adminstrator will have some power over the clinic staff, even if they are doctors.
* Social worker dept

Depending upon how your clinic is organized, contacting one of the above may be a way to get some help. FWKW, I have successfully used all 3 approaches when dealing with clinics and insurance companies.

Other possibilities are simply to take the day off and insist on getting copies of the paperwork that needs to be sent to the insurance company before you leave. I'm not sure if this would work, but its pretty difficult to hang up on someone if they are camping out in the lobby. And if you've been trying to get this done by phone since May -- you really do have a strong case for being a pain in the neck in person.

Or contact the cochlear implant dept of the UCI hospital and ask them to help you with the paperwork. Cochlear implant clinics obviously like to do implants and I have heard of cases where they seem to go above and beyond what one would expect a medical dept to do to help patients with the insurance paperwork.

FWIW, I really don't know much about this area, but I am wondering if you are on the borderline for being a candidate for a CI. Part of the reason I'm wondering is because you said you have been sold a pair of Phonak Nadia SPs which are not the most powerful model of Nadia HAs -- the Nadia UPs are.

Anyway, I'm wondering if some ENTs would say that you are a candidate and some others might say you aren't? I would do everything you can to try to get an objective evaluation, and to get at least two opinions. Its not always easy to get an objective evaluation from someone whos paycheck depends upon what they do. So, if you can, I would also try to speak with an audiology clinic that has a good reputation for fitting hearing aids for people with severe to profound losses and consider carefully what they have to say also.

One of the things I've heard about comparing HAs and CIs is that CIs can be set to give someone more higher frequencies than hearing aids -- but if one is still a candidate to wear HAs they should probably stick with HAs because HAs still offer the advantage of giving you richer details of sound if you have enough residual nerve cells to work with.

Good luck with getting good evaluation appts and making your decision.
 
I understand you frustrated pretty you seems on pretty hard situation clinic

good luck
 
One piece of advice I have is to not provide so much personally identifiable information... It might be smart to edit your name and maybe the names of the hospital and clinics you're dealing with...

Good luck with everything...
 
CSign make a valid observation. How would your clinic react if they read what you said about them?

Implanted A B Harmony activated Aug/07
 
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