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-   -   BCBS of NEW YORK DENIED (https://www.adrsupport.org/forums/showthread.php?t=13650)

GKTM300 11-16-2017 10:53 AM

Website
 
Looks like Bert is updating his websites. He lists two people to contact about insurance claims. His site is posting newer relavant information and he talks about the m6 short comings. I'm betting you will never get a USA Ins company to pay for a non FDA approved device though. I'm pretty sure the m6 will be taken off the market soon. The arguments Bert brings up sound pertanant to me sp

ia75 11-22-2017 10:28 PM

Out of pocket
 
Quote:

Originally Posted by ouchtear (Post 115569)
After months and months of internal appeals and finally a external appeal from New York state it was finally denied. I was going to have a one level l5-s1 done with either a Prodisc L or Activ L at the Texas Back institute. It's such bull****.. No evidence to support it is better than fusion... Then with that logic there is NO evidence to support that it is worse. So then let me chose then... I guess I am at square 1 again.. I may just take a gamble and pay for it out of pocket somewhere...submit it and then fight them like hell to pay for it..

TBI charges $36,000 for a one-level ADR...

ouchtear 04-29-2019 01:55 PM

(Update) WON new appeal BCBS NY
 
The second time was a charm. I went through the process again and won. Had my surgery 11 days ago. My winning appeal letter is on the Facebook adr forum files section. I also used the Laurie Todd Book " How to fight your insurance company and win" as a guide. I am recovering now and hope to get better each day.


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