They stated as did the original letter from the insurance company that ADR was still considered investigational and experimental at this time according to their criteria that is why they denied it. I challenged it through HR since our ins is self funded and hoped they would over ride it but didnt. The underwriters and the panel with the company that my hubby works for agreed with Great West on this. They would not give me an answer when I questioned why it was still considered experimental when FDA approval had been granted in October. All I was told was I had the right to appeal and to send a letter to the Benefits Director. Hubby happens to be in San Antonio right now in a new training class and plans to phone the Benefits Director and see if he can talk to him in person while he is there and see if we can get anywhere with him.
Kim
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Kim
Herniated disc L5/S1 2000 Discectomy 10/2003 Rhizotomy 8/2004 and 3/2005Discogram 11/04 grade 7 tear L5/S1
L4/L5 Grade 5 tear with herniation and stenosis
Evaluated by Dr Blumenthal at TBI
2/2005 ADR 2 level recommended
2 level lumbar fusion
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