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Insurance Hell All insurance-related matters are here: Medicare, worker's compensation, appeals, denials, insights, wins, losses. PRICING is here too. Note: This forum has posts from 2006 forward. Older ones are in the Big File. |
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#11
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Hi Laura, I would greatly appreciate asnything you can send me on your appeal process. I am currently in the process of appealing Cigna Healthcare for my surgery.
Thank you in advance for your help. Judy
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Surgery Vienna by Dr. Bertagnoli Oct. 16, 2004 ADR L3/4 Fusion L4/5 ADR L5/S1 Diagnosed with Arachnoiditis 11/06 |
#12
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Laura: You kicked butt in your perserverance. Also, I wish you the best for your surgery. Finally, thank you for helping others obtain approvals as a result of your v. hard work. - Allan
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Severe, extensive DDD, considered inoperable by Dr. Regan, Lauressen, & some guy at UCLA. Severe foraminal stenosis (guess they can't operate!) and some spinal cord compression that Lauryssen would fix if gets outta hand. |
#13
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Hi. I just receivd a letter of non-certification from my insurance company, Blue Cross. I need a disc replacement at L5. Rick Delamater is slated to perform the surgery (using a ProDisc) on October 5. I would be greatly appreciative if anybody has any thoughts or suggestions as to to the viability of appealing the BC denial.
Alternatively, my wife has Great-West availble to her--does anybody know if they cover this surgery? Lastly, if Great West doesn't, and my BC appeal is not fruitful, I am starting a new job in January and will be able to choose from many insurance companies--which ones cover this procedure? Thank you in advance. dan lowenthal long beach, ca
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dan lowenthal |
#14
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Not that this helps, but, to my knowledge, you are the first person to receive a denial for U.S. Prodisc (that I have heard of)
David
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47 years old Surgery: 14-NOV-2006; Straubing, Germany (Dr. B.) L4-S1: Prodisc |
#15
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You mean companies are approving ProDisc right now? If so, which companies? Rather than enter into a protracted battle with Blue Cross, I'd like to just sign-up with a company that will do the right thing.
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dan lowenthal |
#16
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What I mean to say is that Prodisc was FDA approved about two weeks ago, I seriously doubt that any insurance company will cover Prodisc surgery for quite awhile.
(ie, you are the first person to post that has asked for Prodisc coverage. I plan on waiting until mid-October to ask for my Prodisc denial) Charite was FDA approved in 2004, and many insurance companies continue to deny people for that a particular device. David
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47 years old Surgery: 14-NOV-2006; Straubing, Germany (Dr. B.) L4-S1: Prodisc |
#17
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Laura,
Congratulations to you on your approval. I went through three appeals back last year when i finally got my approval for ADR surgery at the Texas Back Institute. My insurance was BCBS also. I am glad you stuck with and won. Mark |
#18
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Laura,
Have you had surgery yet? If so, how are you doing? |
#19
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Dan ~ are you in Long Beach? So am I..
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#20
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Yes, I am in Long Beach--my family lives in the Rose Park area. My local physician in Eric Feldman--he referred me to Delamarter.
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dan lowenthal |
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