In January of 2025, we were at a low point with my 8 year old daughter, who had severe gastrointestinal issues. She had gone through multiple medications, nothing was working. She was missing school, sports, and life as the pain was so bad. Her gastro suggested a device called an IB STIM. We went through the process with insurance and was told it was pre-approved by the doctor's office. She had the device and it worked wonders.
A few months later, we received a bill for $3300 because the insurance denied it due to the treatment being "experimental" or "investigational". The doctor's office said verbally it was pre-approved and didn't understand why we were being charged as the device is FDA approved and has scientific research published through peer-reviewed medical journals abuot the efficacy of the device.
We filed a first level appeal and got denied, then second level appeal and denied. With both appeals, the doctor sent over her health records, a letter of medical necessity, and the history of things we tried. Finally, I called the state board of insurance and now we have a hearing with a board made up of individuals who have not been part of the process prior.
What do I expect at the hearing? I have a choice to go in person or by telephone. I just want to make sure that I know what to say/do/present as we can't afford this $3300 bill and would've never done the treatment had we known.