Newest Update

[Nichole]

First of all I want to say thank you to all of those who have listenend to me throughout this whole ordeal. Thank you to those of you who have emailed me information and your phone number for me to chat with on a more personal note.

I just wanted to give you an update. I have spoke with my insurance company regarding my appeal process. Unfortunately I was misinformed about what level of the appeal process I am on. I was under the impression that I am now on my second level. Unfortuantely I am still on the first level. The first denial was just the preauthorization. So......I rewrote my appeal letter with the help of Leanne and many others who have passed alot of wonderful information on to me. I faxed a 180 page appeal letter to my insurance this morning. I called to inform the appeal coordinator that 180 pages was being faxed over and I think she just about had a heart attack. I know I would. heehee The more the merrier I think. Anyway, I have alot of great information online if anyone needs some more paperwork for their appeal process. Just message me and I will be happy to pass along whatever can help. I also have a 120 page document from the FDA regarding the approval of the CHARITE artificial disc. I havent seen this posted anywhere. The manufacturer send me this copy.

I should hear next week sometime the decision of Regence regarding my appeal. Thank you again to all of you who have helped me this far. I consider you all brothers and sisters in the spinal community.

I'll let you all know when I hear something.

Nichole

[NCFUSED]

I am in the same boat, but at least my Doctor is helping with the appeal process, he is putting together the information and contacting the insurance company for me. Although it is taking longer than I would like. My insurance company claims that it will make a decision on my appeal within 15 days or 78 hours if the doctor says this needs to be expedited due to medical complications....
I did call my insurance company to check on my Doctor's progress, I was surprised to speak to a Woman in Care Coordination that encouraged me to appeal due to my age (38) and the fact that fusion will limit my lifestyle.

Good Luck in Your Appeal, I have my fingers crossed for both of us!

John
Greensboro, NC

Herniation and Degeneration in L5-S1
Awaiting ADR Approval since 11/04.

[Harrison]

John, do you think your doctor will provide a DNA sample?! I think we should clone him!



'Hope you both make good progress...

[NCFUSED]

After dealing almost a year with a neurologist who would only send me to PT (which I think made my condition worse) and kept me in a drug induced semi-comatose state, I switched to a neurosurgeon in Greensboro, Dr. James Hirsch. He originally prescribed fusion, but told me if I could stand the pain a few more months to wait and see about ADR (Charite). Now my only obstacle is the Insurance Company and probably some hack Doctor there that couldnt make it in the "real" world of medicine..... I thank god that he is willing to take up my battle for me, from reading some of the Insurance Horror stories, I wouldnt know where to begin....

John

[JeffreyD]

A doctor who will "go to bat" for you and cares about his/her patients at times other than when the patient is on "billable time" is a very rare item nowadays. You are fortunate!
Jeff