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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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#1
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Hi All you Spineys!
I could realy use some help! My lawyer (only took me forever to find one that would take my case) wants me to give him all the study findings I can and I have a few from Canada and the Aussies. But...I need ones specific to cervial ADR outcomes. Any links to those studies would be MUCH appreciated! Also any well noted surgeons names that deal with this as well!Last but not least does anyone happen to have a list of the insurance companies they know for sure have paid for ADR or specificly Prestige Cervical ARD? I looked through the list of companies denying but need to know who is covering! Just got the lawyer appointment today for 5/9....Yikes I have a lot of getting my s**t together by then, typing notes up and all the info I have found! I bet my neck will feel great after all this computer time! Thanks and thanks again! Janey
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*c/6-c/7 herniated disc /pinching nerve causing extreme and radiating pain in back-neck and nubness in left arm and compressing spinal cord from 13mm to 6 mm- cervical steriod injections-physical therapy-lots of meds-* CIGNA insurance revoked my F |
#2
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Jayne
If you get anything I'd surely like copies for myself. They are very difficult to find, as you've discovered. Wish I had something for you, but am on the same quest. Good luck to us both! Missy mdm798@aol.com
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fusion L4-5, Dynesys rods L3-4, fusion c5-6 and C6-7, current problem C-7/T-1 |
#3
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I believe I left a similar message here the other day concerning the Prestige Disc and Insurance coverage. I had 4-level ADR surgery November 4, 2006; two Prestige discs Cervical, two Maverick discs Lumbar and, Blue Cross/Blue Shield of Michigan payed for the entire surgery that was done at Stenum Hospital in Germany and, they have payed for all of my follow-up care since coming home to the States. My surgery was close to $61,000.00. Plus I won my lawsuit in mediation over the accident that caused my spine's final demise and got about $74,000.00 from that. Three years of my life were involved; surgery to repair my shattered clavicle, surgery to repair my lumbar and cervical area of my spine and now, to be never the same again, I don't think I got a bargain out of the deal. It's a hellish way to make money.
Good-Luck to you. Terry Newton
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1980 ruptured L4-L5 1988 ruptured SI-L5 1990 ruptured C5-C6 1994 ruptured C6-C7 1995 Hemi-Laminectomy C5-C6, C6-C7 Mayo Clinic Bicycle Accident 2004 MRI, EMG, Facet Injections, Epidural Blocks, Lumbar Discogram. Stenum Hospital Surgery November 4, 2006 Prestige Disc C5-C6, C6-C7 Maverick Disc S1-L5, L4-L5 |
#4
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Thanks so much for the info Terry! What a horrible thing to have happen! How in the world did you get your insurance to cover out of country surgery?
Thanks, Janey
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*c/6-c/7 herniated disc /pinching nerve causing extreme and radiating pain in back-neck and nubness in left arm and compressing spinal cord from 13mm to 6 mm- cervical steriod injections-physical therapy-lots of meds-* CIGNA insurance revoked my F |
#5
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Janey:
I am the Executive Director of the company I work for. I answer to a Board of Directors and one of them sells Blue Cross Insurance to companies. I believe he put in a good word for me. After two denials and no appeal from me they covered it all in a matter of a few months. Sometimes it's who you know unfortunately. Terry Newton
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1980 ruptured L4-L5 1988 ruptured SI-L5 1990 ruptured C5-C6 1994 ruptured C6-C7 1995 Hemi-Laminectomy C5-C6, C6-C7 Mayo Clinic Bicycle Accident 2004 MRI, EMG, Facet Injections, Epidural Blocks, Lumbar Discogram. Stenum Hospital Surgery November 4, 2006 Prestige Disc C5-C6, C6-C7 Maverick Disc S1-L5, L4-L5 |
#6
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Janey, I also am fighting insurance for Lumbar ADR 3 level. What I did is I contacted the Drs who perform this surgery and asked them for copies of their medical journals on the subject. Most were happy to provide it. Also, could you send me some info on your lawyer. I am looking for a new lawyer and the one I have been working with doesn't want to file a civil suit under ERISA. thanks eileen
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#7
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Hi eileen,
My lawyer can practice in MO and KS. Do you live in either of those states?
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*c/6-c/7 herniated disc /pinching nerve causing extreme and radiating pain in back-neck and nubness in left arm and compressing spinal cord from 13mm to 6 mm- cervical steriod injections-physical therapy-lots of meds-* CIGNA insurance revoked my F |
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