DWebster- ALL my sis-in law has added to this is the fact that what is more cost effective is not the issue. THey also do not care about the costs involved with apprvoed med's or the risks to the patient in their long term use.
If they can get by without paying by saying experimental or not enuf long term data they will. They are not there to pay for every claim that comes in willingly.
The fact that they would have paid 150K for a 2 level fusion also is just how they do things so cost savings is not ironically an angle.
The only hope is saying to ask for a exception based on medical necessity & the fact that this surgery is the same prep work required as in a fusion or Charite ( I had P.D.) & that to ask they pay for all but the device then since it is the same prep work & to keep hanging in there. If bothered enuf & it may require an atty. & the threat of a jury trial - maybe in time at best they may offer a partial settlement. We were not turned down until after my surgery & we had gotten back home - we had a case number & they sounded encouragaing this was not a problem, although they never said offically yes.
Jill L4L5 P.D. Dr. Bertagnoli Straubing Germany