Self Paid because insurance refused to Pay

[breckpetekaren]

My summary:
2005 disc fusion of C5-6
2007 partial discectomy of C6-7
2008 replaced disc at C6-7 with artificial Prodisc-C
2011 replaced disc at C4-5 with artificial Prodisc-C
Disc replacements performed by Dr. Paul McAfee in Towson, MD
I have Degenerative disc disease.
Cigna insurance paid for the first 3 surgeries and then on the 4th said the Prodisc-C is expeirimental.

[Harrison]

Pete,

It's amazing isn't it -- the hurdles one must face -- after winning the race of pain management, research, finding the right option...then bing punished financially. It is nuts.

Please tell us how you are doing! How is your pain? QOL? Is your "experiment" a success?!

[DAnn]

Pete,
I don't understand why insurance companies say that (I'm going through the same issues) when it has been through the rigorous process of FDA approval.

Perhaps it is the two level ADR, but you had them done at different times.
It must be frustrating, but I hope you are feeling better and get well enough to fight insurance later.
Take care,
DAnn

[Jstuckey]

APPEAL APPEAL APPEAL. Maybe it just got in the hands of an old chronie that doesn't believe in these new gadgets. I'm appealing for the 4th time. A different third party reviewer sees it each time, and I'm hoping someone with half a brain gets their hands on my situation. You would seem to have a very strong case - 3 times paid? APPEAL!