Hi All... I'm considering ADR for single level at L4/5 for DDD. I have an annular tear and recently had a Discogram to confirm what we already knew. I just got my denial letter from Anthem BC in CA for my ProDisc-L, but immediately working on the appeal and plan to file an IMR with the State. I found a nice reversal from a 2007 S.C. Administrative Finding reversing BCBS denial for a members prescibed ADR and the decision seems to be the exact information everyone should use for their states IMR process. Especially when dealing with BCBS organizations...
Juliana Antonelli vs. SCBCBS
SC Administrative Law Court - Decisions
Good luck all!
I.