catheter ablation

[Jim8038]

I was hospitalized for atrial flutter and had a cardio aversion to get back in rythm. A cardiac ablation was scheduled to correct the problem in my heart and my insurance (coventry) denied coverage. I am 50 years old and have had a previous blood clot in chest. They said that 2 of these needed to happen for it to be covered. My question is am I at a higher risk of stroke waiting for this second episode to happen? If I am why in the world wouldn't they cover it?

[Jim8038]

Thanks for your response. The Dr. that was going to do the procedure did call and stayed on the phone for awhile speaking with the medical director of coventry. He also sent studies that showed it was less risky to do this procedure than wait for another episode. Still the answer was, studies were not big enough or not conclusive. They still denied coverage. Coventry is the only big insurance company that is dening coverage for this procedure with the same issues.

[ksig]

Hi, Jim
I would ask the doc to write a letter to the insurance co telling them that your procedure is necessary.  I had a couple of things denied and all I did was call the doc's office and have them deal with it.  I had all procedures and tests.

On another note, you may call them yourself to find out more info but I'd let the doc's office handle it first.

I wish you well and hope you are in the cath lab soon.
ksig