ESL is totally correct, after 2 appeals with UHC,
which really were a waste of time because my company is self insured, the final denial letter from UHC told me to seek another appeal from my employer's benefit's committee, that they were the only ones that could overrule the medical policy that was in place.
One other thing I found out is with Self-insured plans, you cannot appeal to the state's insurance board. You would have to file a grievence with the Dept. of Labor, basically "marking" yourself at your job....
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John
Greensboro, NC
DDD L5-S1
Lost all ADR Appeals w/ UHC PLIF Fusion L5-S1 on 5/17/05.
Pars Defect L3-L4
DDD L3-L4 L4-L5
3 LVL Fusion Scheduled 4/08
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