Independent Medical Review?

[cttom]

Can anyone tell me what to expect? I have approval for one disc. Pushing for second. I don't want to come across as too agressive. Any tips on how to posture? I think the Dr.'s group has performed ADR.

Any tips would be greatly appreciated.

[Harrison]

This is a tough one -- especially since you seem to be fighting workman's comp. Each state has a consumer protection department for medical appeals -- Conn. has a particularly strong one. Call them, get to the right person for advice. Also, you are able to receive copies of previous appeals that went through the independent appeals process (it may take some time).

Watch out for these snafus:

- the examiner being a doctor in another medical field -- or country;
- when writing your appeal, stick to the facts (see Laurie Todd's book -- search these forums for the "Insurance Warrior);
- not distributing to ALL the right people in the insurance company(s) and appeal organization.

There's more, but you get my drift. BTW: Are you already in contact with Synthes? They have a strong appeals support partner to help patients with this stuff.

Hope this helps.