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-   -   List of Who has been denied ADR (https://www.adrsupport.org/forums/showthread.php?t=6454)

LBP 01-29-2007 01:17 PM

I would like to start a list of people who still have been denied ADR surgery by their insurance company.

What city do you reside, how many levels do you need, and who is your insurance company that denied you. Please specify if you are a workers compensation case because that is a whole different animal.

I am curious to know how many people with single levels still aren't being approved or are they only ones with trouble the ones with multiple levels?????


Anyone interested in posting your information?

Maybe it would be good to also include those that have paid out of pocket to go to Germany because they were denied by their insurance company.
re: lawsuit...highly unlikely in light of another thread discussing ERISA. Still good info to list what companies are not paying up!

LBP 01-29-2007 01:18 PM

I'll start,

Need 2 levels, L4/5 and L5/S1. In 2005, was turned down by Pacificare/UHC PPO for 2 level Charite. Insurance was employer provided insurance from when I used to work in San Diego, CA. Later also denied for a combination Charite at L4/5/fusion L5/S1, same insurance via fed and state extended COBRA while living in Milwaukee, WI. Fusion was tentatively approved but not the Charite portion. Currently reside in Milwaukee, WI. Exhausted all appeals, including appeals with CA Dept of Ins.

chasswen 01-29-2007 01:27 PM

me me me i was denied a single level adr charite blue crap.
chuck

JFerg 01-29-2007 05:13 PM

Put me down........denied 3X's United Health Care - 2 levels.
I support your right to petition. Let me know if I can help in any way.

Terry 01-29-2007 08:31 PM

Blue Cross Michigan denied 2 level Charite discs done by a surgeon approved and on Harrison's list of Charite surgeons. I went to Germany and paid out-of-pocket for 4 level ADR.

I sued the homeowner's insurance and Blue Cross maintained a lien against the suit. In order to get rid of the lien I had to waive the right to appeal. Nifty.

Terry Newton

Brad 01-30-2007 11:08 AM

Denied by Cigna PPO in California. went to Germany, now pain free and happy.
I hope the insurance geek that denied my coverage has a bad back......let him suffer.

Brad

Nairek 01-30-2007 08:58 PM

Denied by Empire Blue Cross Blue Shield for a 1 level Charite ADR at L5-S1. Currently on my 2nd level appeal & keeping all fingers, toes, & eyelashes crossed that I will get the denial overturned! http://adrsupport.org/groupee_common.../icon_wink.gif

Texas-T 01-31-2007 07:47 AM

I was denied a single level L5/S1 Charite from United Health Care.

I was later approved by Aetna when I switched insurance companies.

Kim 02-01-2007 10:07 AM

Denied by Great West Healthcare for a 2 level lumbar ADR L5/S1 L4/L5

Abbe 02-15-2007 10:51 AM

I have been denied by Blue Cross Blue Shield of California. I am about to start the appeals process and am waiting to get a copy of Dr. Lytton William's letter so that we can be in sync. I did find that Prodisc has a place on their website for others in the appeals process and an 866-223-0508. There are Patient appeal letters and surgeon resources. Not sure if this will help my case or not but I am open to suggestions.


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