7-month-old gets surgery to save hearing after originally being denied due to insurance issues

Nathan Hart was checked into Le Bonheur Children’s Hospital on Dec. 19 with bacterial meningitis.
Published: Jan. 5, 2023 at 12:55 PM CST
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MEMPHIS (WMC/Gray News) - A 7-month-old boy in Memphis received a surgery meant to save his hearing after it was originally put on hold due to insurance issues.

Nathan Hart was checked into Le Bonheur Children’s Hospital on Dec. 19 with bacterial meningitis.

His parents, Melanie and Tyler Hart, told WMC Nathan had severe hearing loss.

“It affects the liquid in your ears,” Tyler Hart said, relaying what doctors had told him. “What will happen is that liquid will turn to bone, and (doctors) will not be able to do the surgery if it turns to bone.”

The solution to this is bilateral cochlear implant surgery, and the Harts said Nathan’s surgery was set for Tuesday morning.

The surgery was scheduled during the last week of December, when Blue Cross Blue Shield of Tennessee was still accepted at Methodist Le Bonheur Healthcare facilities.

However, WMC reported Blue Cross Blue Shield of Tennessee and Methodist Le Bonheur Healthcare failed to renew a contract by the Dec. 31 deadline.

As of New Years Day, BCBST customers are no longer covered at Methodist Le Bonheur facilities, which included Le Bonheur Children’s Hospital.

The Harts said they were given no notice in advance of this possible contract fallout when they scheduled the surgery last week.

“(Le Bonheur) said surgery is set for Tuesday,” Melanie Hart said. “They come in on Tuesday morning and told us ‘We’re going to get (Nathan) set.’ Then, an ENT came in and said ‘I’ve done all I can do, but due to insurance, we can’t do the surgery.’”

The Harts were frantic. Melanie Hart said Nathan would be deaf the rest of his life if he couldn’t get the surgery done within 48 hours.

With such a short window to get Nathan the surgery he needed, the Harts offered to pay out of pocket with a payment plan, but Tyler Hart said the hospital wouldn’t allow them to do that because of the high cost of the procedure.

“$60-something-thousand an ear,” Tyler Hart said. “They want to make sure it gets paid, so they want to get insurance involved as much as they can.”

The Harts said they reached out to Blue Cross Blue Shield of Tennessee multiple times but felt they were being given the run-around.

Le Bonheur is the only hospital in the area that can perform this surgery, and with such a short window to perform the surgery, driving to another state for care was not an option.

“We don’t even know who to go to or who to speak to,” Tyler Hart said.

A spokesperson for Blue Cross Blue Shield of Tennessee said the Harts’ contact information had been forwarded to “the appropriate teams for follow-up.”

On Wednesday evening, Melanie Hart said the insurance company contacted them. They said the surgery for Nathan was approved and would be covered under insurance.

Nathan’s surgery took place on Thursday.

The Harts have set up a GoFundMe to help pay for any expenses insurance does not cover.

At this time, there is no indication of when a new contract will be approved between the hospital system and Blue Cross Blue Shield of Tennessee.