Insurance denied revision

The final frontier. Deciding when, if and how.
MK1965
Posts: 625
Joined: Thu May 24, 2018 5:32 pm

Re: Insurance denied revision

Postby MK1965 » Wed Sep 09, 2020 12:56 pm

Bridge,
My implant did not failed. Problem is I have significant pain by inflating it to 50-60%. Had pelvic mri and it was found that my right cylinder is not properly positioned in right crus. RTE is poking my right side of penis at penile base on top of suprapubic fat. I can’t have intercurse any more and it is almost 3 months since last intercurse.
My doc even suspected that it is subclinical infection and I finished 2 courses of antibiotics but pain is not getting any better. It is much stronger compared to last 2 months.
My doctor wrote letter of medical necessity for revision of implant but insurance denied it 3 times.
No idea, what to do?
MK
IPP 9/5/18; TITAN OTR 18 +1cm RTE,Prostate Ca at 51 y/o; RARP 11/2/16, ED Post RP, Cialis, Viagra, VED,TRIMIX painful, BIMIX ineffective,lost 2+ inches of length after RP. Revision 12/2/20 by Dr Clavell, AMS 700 CX, L 21 R 21+1.5 RTE.

DougAnd
Posts: 1536
Joined: Sun Jul 08, 2018 5:10 pm
Location: Melbourne, Florida

Re: Insurance denied revision

Postby DougAnd » Wed Sep 09, 2020 1:53 pm

MK1965 wrote:Bridge,
My implant did not failed. Problem is I have significant pain by inflating it to 50-60%. Had pelvic mri and it was found that my right cylinder is not properly positioned in right crus. RTE is poking my right side of penis at penile base on top of suprapubic fat. I can’t have intercurse any more and it is almost 3 months since last intercurse.
My doc even suspected that it is subclinical infection and I finished 2 courses of antibiotics but pain is not getting any better. It is much stronger compared to last 2 months.
My doctor wrote letter of medical necessity for revision of implant but insurance denied it 3 times.
No idea, what to do?
MK

Mk,
You have had a boatload of bad luck. Before my distal crossover was found I had checked into having a surgery done at the crus to fix an RTE. My left side was and still is much shorter than the right. Anyway fixing your RTE is much less invasive than a complete replacement. It is tricky so if you try it do find a qualified surgeon. Hang in there man the light is coming!!!!
LGX 18cm+3cmRTE 8 / 8/18 by Docs Saracino , Prody of FL Disfigured by Implant. Married 31 years, Functionally impotent 2+ years. 4" day of surgery now 7" inflated after VED 6.5" without. Pump moved 12/4/18 by Dr Kata

MK1965
Posts: 625
Joined: Thu May 24, 2018 5:32 pm

Re: Insurance denied revision

Postby MK1965 » Wed Sep 09, 2020 3:27 pm

Doug,
Since my RP for prostate Ca, my light is very dimmed, barely visible.
Nothing is going in right direction. I am tired of fighting Insurance.
I just want it it to be over. I am working for internationaly know hospital in SF Bay area but insurance is total crap. Insurance even did not approve me for robotic prostatectomy so I needed to file appeal to get approved for Da Vinci robotic surgery. Insurance never paid for any drugs for erectile dysfunction after prostate removal. I like my job working remotely and I do what I know the best but it might be time for job change.
MK
IPP 9/5/18; TITAN OTR 18 +1cm RTE,Prostate Ca at 51 y/o; RARP 11/2/16, ED Post RP, Cialis, Viagra, VED,TRIMIX painful, BIMIX ineffective,lost 2+ inches of length after RP. Revision 12/2/20 by Dr Clavell, AMS 700 CX, L 21 R 21+1.5 RTE.


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