i am new to this but am very interested in lawsuite against bc. i have bcbs of north dakota through my employer and they are saying pro-disc adr is investigational. i am in the process of sending 2nd appeal.

Best wishes. I appealed my insurance (not BCBS) 4 times and was still denied with the "investigational" claim. In my case, they said (only on the last appeal when actually looking at my entire medical record) that it was the multiple level deterioration that had not been studied, therefore making it investigational for that use. (I would have had a fusion below and 1 ADR). So they would have paid if it was a single level? I highly doubt it....
Borrowing a ****load of money from my parents instead....

Anthem BCBS L5-S1 denial
 

I would like to join forces with anyone who has experience with Anthem BCBS or any other BCBS for that matter.

I'm in need of any successful coverages, appeals, court cases, etc. for lumbar ADR.

Blue cross
 

We sent a summarization of my nightmare to a health care attorney.

I'm in the midst of a battle with Anthem myself. Just got my first denial back today. Am waiting to see if they will approve a repeat discectomy (which will leave so little disc they will have no choice but to do a fusion or ADR), before I decide about the 2nd appeal. Will hopefully know something Wednesday. Evidently our Anthem policy is the only type that does not require pre-cert for lumbar fusions!

Thought this was on my signature already - 2x epidural spinal injections, 3 mos physical therapy, herniation at L5-S1 w/microdiscectomy on 7/5, re-herniation shortly thereafter

Doctor who performed appeal made numerous factual errors based on info submitted by doctor to go with appeal. Does that matter in anything?

Has anyone been successful in Suing BCBS?

I am very intereted in BCBS as I hav it in Alabama and was told that disc replaement would not be covered. I am also planning on getting a lawyer when the decision is made on what Dr. I go to and what disc is decided that would be best for me. Im such a noob here also lol.