Folks,
As we now know, suffering patients need legal help fighting the bean counters, actuaries, lawyers et al in �mahogany row� at the big insurance companies.

When patients desperately need insurance coverage for ADR (and other arthroplasty procedures) I�d like to be able to offer resources to patients in different capacities:

1. Organize a volunteer network of people that can help patients do their best to follow the bureaucratic appeal processes of insurance companies, gratis;

2. Organize a network of both medical and legal professionals who will work on a nominal fee basis to help patients win coverage;

3. Organize a network of professionals (all types) that work for fees (market rate) to help patients fight and win coverage.

If you can help build & implement these support functions on a long term basis, please let me know. As well, if you feel that you have the right credentials, commitment and passion to help people, let�s talk next weekend (pls provide phone number).

The insurance companies self-serving behavior should not continue �rationing� health care where it is so badly needed!

info@adrsupport.org

Wow -- no reponses? No help for the community? What a drag!

I also got nothing back when I asked for everyone that had Cigna insurance and were waiting for ADR.

Brady

Sorry Rich,
I'm a slacker. I admit it. I don't have legal or medical training.

Jim

I would take Hartford (County) CT unless someone wants to pry it from me. Reading this post last week, my initial thought (fear) was; How can I help someone else when I can not help myself ? Also this appears to be a huge task until I broke it down. Two answers came to me. 1.) I AM having successes because of all the contacts and information I have received here. Making calls is one of my best assets and I can dial a few numbers for the common good. 2.) Recently I received a call from someone (lawyer) who has watched me go through this for eight years and their co-worker has ADR exam this week. Did I say two? 3.) I know a little something about Insurance and where the front doors are in Middletown, Bloomfield, Hartford and Farmington and I am not afraid to knock on them. 4.) I believe in the support of this community and it is looking like a lifesaver more and more every day. Someday I am going to post how much energy, clarity and optimism I have regained since my ADR only 4 weeks ago. Rich, you got my number. Bill

Rich,

Must say that the legal thing scared me away. But I am great at organizing and stirring the pot so to speak. Always want to learn more and help others. Count me in these days as I need more to occupy my time and would love to give back to the community anyway I can. http://adrsupport.org/groupee_common...icon_smile.gif

Rich
I dont know how much help I can be but will be willing to do what i can. I have been out of town and just saw this post and totally agree we need to unite to get something done about this poor coverage of ADR here.
I do have medical and insurance background but as we all know the laws vary so from state to state it is a big kettle of fish.
kim

Just got back to my PC. I was gone a few days.
I think you have a great idea and it would be great to put together a support team with legal
guidance.There are people in every walk of life with back or cervical problems and hopefully
some attorneys or insurance professionals with
expertise in the areas needed will be able to help with some ideas.
I would definetly try to devote some time to help
out, if nothing else maybe we could start some
kind of fund or if there are any spineys with connections to people in music for example, and
maybe put on some kind of fund raising concert
to help start a legal fund. I have my new discs
as you know but I sure feel sorry for all of
the people out there suffering and especially
people like a very close friend of mine who is going thru the routines the insurance companys
put people thru with all the regimines of meds
to finally get something that really helps them
or the steps it takes to get just approval for a MRI which I'm getting ready to post some questions
about meds and treatments. The info from people
on this site has really helped me alot.For what
ever I can do to help count me in.
Chuck Dobovsky

Rich,

I am willing to do whatever I possibly can to help out with this issue. I have a background in case management regarding reimbursement issues with insurance companies from a clinical perspective.

I obviously don't know everything there is to know about this - but willing to share what knowledge I have to help assist.

not a lawyer or a medical professional here, although maybe i missed the boat....i'm jewish
but am willing to help in anyway possible, just not sure i can..... {:------)

My background has been in healthcare for 25 years working as an RN and Nurse Practitioner. Have worked clinically in most medical settings and have worked as an administrator also. Have written policies, procedures, protocols, orientation manuals for depts. Worked with Quality Assurance for several years.. written grants.. done telephone triage Advice nursing..
yadayada... might be helpful and am definately available to try and help out~

I forgot to Mention that one of my roomates
girlfriend has been working for a work Comp
company for about 20 years and is very knowledgeable on all the new changes and rules
with Work Comp Claims if I can be of any help.
Chuxk79

I have to be honest. I don't know what help I would be to someone else when I can't accomplish it myself but I am willing to help if there is something that I can do. I was a nursing assistant (that's how I hurt my back) and that is all of the medical knowledge that I have other than about myself. I don't have any legal training.

I'm studying to become a paralegal but I don't think I can offer that much help. The legal books at school are very limited but I'll have access to Lexis-Nexis (huge legal database) by the end of August. Not sure if this helps.

I've written quite a few appeal letters and gone through the grievance process a lot with Blue Shield in CA. I'm also in HR.

Gem

Thank you all very much; I'll be in touch over the coming weeks.

I am exploring the best way to organize this (thoughtful & committed) network. E.g., I wonder if using Linkedin (which I use for my professional contacts) may be the best way to proceed / organize).

I have been away at fair with my kids, so I just got tjis message. Count me in! I am gathering momentom here in Wyoming. I dont have any legal training, but I am great on the phone and can call anywhere in the country with unlimited minutes. I never hesitate to call people I dont know. I would like to send you a copy of the flyer I am sending to sevsral Drs offices for approval in Wyoming and Colorado. Call me, BrendaWY

I've just found this post.
I'm based in the UK and am a doctor, A General Practioner (I think I'm called a 'family doctor' in the USA) I have recently undergone an ADR. I''ve not been working for the last 6 months due to my back, but plan to go back when possible. If I can be of any help please let me know.

Harrison-
I would like the chance to give something back. I'm a licensed social worker and I've been on the provider side of managed care for many years, so I can speak the lingo. Let me know what I can do--phone calls, letters, whatever.
Anne

Harrison,
Though I have neither any legal nor medical knowledge, I'd be happy to offer my assistance. I'm a bookkeeper by trade and am great at organizing and streamlining.

However, it would seem that the best way to refute insurance claims would be with a study because that is what they state as their basis for denial. If studies proved, etc, etc, etc, that adr's provided better relief than fusion or other accepted practices, insurance companies would have no legal standing in denying claims.

I have no idea how one would go about formulating a new study, but it would be the quickest way to get where we need to go. Surely there should be enough data at this time to formulate positive statistics.

Just an idea,
Dale Stuer