Is it possible get ADR in Europe and still be covered by insurance?
 

I live in Chicago and I have DDD at L5-S1. I have BCBS insurance. I went to a local surgeon who can put in the Pro_disc, but he told me that BCBS never approves ADR even with Pro-Disc.

So, it is sounding like I will have a fight on my regardless. With that in mind, if I am going to have to fight I might as well try and get the M6L as I feel this is a better product.

Does anyone know if these is even feasible?

hey
 

I have BCBS and hey gave me an address
www.bcbs.com/bluecardworldwide
i already checked and the spine center in spain is not on there list, so you would, as it was explained to me. have to get the suregery then YOU would have to file it, of course get denied because (my plan doesnt pay) . My plan is a PPO. THen you would of course have the fun of apealing and all that, if that is the route you want to take anyways. The Spine Center is the only one I checked on over-seas. I have also been checking into the Texas Back Insittute. I think some people on here made some good referances to Dr. Blumenthal??? trying to find that post again. lol
Allison

Ally, I think the spine center is part of Quiron Hospital... Which is listed on my policy.

and what insurance is that? I have Cigna and i am getting a 3 level ADR done Oct 17th by Dr. Clavel

Thanks for the information!

I looked into this and the BCBS International website has Hospital Quiron Barcelona on their list. This gives me much hope, btu I know there is a huge obstacles in my way nevertheless.

With this information, should I go ahead and
fill out a BCBS International Claim form, or is this one of those cases where you ask for forgiveness instead of permission?

Hi all

I tried to post earlier but my internet dropped & I lost my post!

Breifly, I spoke to a friend who does coding for doctors, hospitals and she indicated to me that one of the biggest issues with getting reimbursed is getting the correct codes. She said that Europe is using a newer codes and they differ from the codes the insurance companies in the USA use. I have sent her a message to confirm, but I believe she said Europe is using ICD-10, however, the insurance companies in the USA are using ICD-9. She suggested to me that I request billing from Dr. Clavel using both coding systems, but indicated that the old one is the one most insurance companies will work from.
She was very hopeful that she could help me get reimbursed at least a portion of my surgery costs IF I get the correct coding.

I will confirm that ICD-9 is the correct coding and post again ASAP.

The surgical company that I had my ADR through contracts with Allianz who owns BCBS. At the time of my surgery, they didn't have that contract in place.:( Otherwise, I would have been willing to deal with the whole insurance circus in order to save a few bucks.

I can tell you more about my experience if you want to know. It was great and I am living with so much less pain. My surgeon, Dr. Mark Peterson, was wonderful. He was so good, that I would have another ADR done by him in a heartbeat. (Hopefully, I won't have to. Knock on wood).

My surgery, by Dr. Clavel was Oct. 24. As soon as I can get everything together & I order I'm going to BCBS to attempt to get them to pay.
Hopefully,if enough of us protest, contest & fight the insurance companies we will prevail and get them to pay! If anyone has hints or suggestions p,ease let me know! I know I have a big battle ahead... One I want to WIN!:wiggle:

Make sure you check to see what kind of doctor reviewed your case. If it isn't an orthopedic surgeon or a neurosurgeon appeal based on that fact. I just had a urologist deny my spinal surgery! :insane: