ADRSupport Community - Ins approval-rescended a NEW way-Please Read

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- - Ins approval-rescended a NEW way-Please Read (https://www.adrsupport.org/forums/showthread.php?t=7423)

Best wishes to you in your upcoming procedure. Keep us posted!

This is a classic anti-trust case fact pattern. Insurance companies or any companies conspiring/colluding in an anti competitive manner to reduce competition (e.g. choices) for consumers/patients. State and federal Attorney General's should be interested in this bad behavior. Even Medicare wrote that denying claims for all ADR surgeries would have a cooling effect on this new procedure, due to their power and influence in the medical community. This may not rise to a RICO case, because in such a case we need a criminal enterprise, and anti-competitive actions may not rise to crimes. This would be a good story for an investigative reporter (60 Minutes or Anderson Cooper....)

Quote:

Originally posted by LBP:
Coley,

with the news about the ins companies getting together and almost seeming to collude on how to create a new policy...I am wondering if there is anything rising to the level of criminal activity for a district attorney to investigate...not just an invidual civil lawsuit. Your facts are very unique. Do you have anything in writing about the reasononing? Like there was a meeting with out ins co to pay only what medicare is paying?

Re your pain and surgery. I am sorry for your pain and I don't know anything about the other procedure you mentioned. best of luck. I just find what happened to you so alarming for the future of ADR.

D,
I am so sorry for your insurance problems. I hope you can get adequate coverage for this new proceedure you are considering.

Jane

Update:

AxiaLIF fusion surgery is scheduled for July 23, 2007 @ 10:30 a.m. @ Northwest Surgical Hospital in OKlahoma City.

This is the quickest surgery date available because the surgeon will be out of town....oh well, I can't wait any longer for the disc replacement. Like the surgeon told me, it may take months or years for the insurance co's to agree to pay a reasonable amount for the surgeons services. If I try to wait, I may be bed-fast even on the pain pills.