Insurance getting easier?
 

I've been working with Aetna for a few days now. They're leaning toward helping but I can tell they'll push back somewhat.

My company is self insured and Aetna manages the plan. I contacted our insurance specialist (the same one the forgot to pay me disability payments for 3 months) and she's trying to help with our company's position. With both entities on a conference call, our rep urged the Aetna rep to find the coding for the ADR surgery. She then had him transfer us to a specialist to locate an ADR surgeon in the US. I'd imagine I'll have to sell the cost savings of an operation in Germany as opposed to a domestic (much higher priced) procedure.

It's not much, but it's a start.

Codes
 

For what it's worth, we've talked about codes many times, here's one old topic here, which does contain some codes. I believe they are still valid.

PS: please insert a signature (brief history) when you can. :look:

I have the aetna codes if you need them, just went through this and got my surgery done. PM me and i'll give you what I have.

Aetna codes
 

Thanks to you both for the offer of the codes. I found them on the Synthes site and forwarded them to Aetna on Wednesday. They also located 3 surgeons in our area that use ADR technology. Unfortunately for me, they only perform the cervical procedure. My wife is excited though. She's going to schedule an appointment with the head of Emory Spine. He's also a teaching orthopedic professor at Emory University here in Atlanta.

My wife went by the last ortho clinic to pick up copies of my last X-Rays and lowered dosage prescriptions for Percocet. Instead they gave her the medical notes from day one. After reviewing them several times, it looks like after my original surgeon left the clinic, I've been treated by Moe, Larry and Curly Joe.

None of the ensuing surgeons/ consultants referenced any disc level except L5/S1. The pain management doctor has been treating me per their diagnosis.

It looks like I get to start over. I think that's for the best now that I'm much better educated, have a lot of support and will be able to better understand the disease, treatments and FDA/ insurance imposed limitations.

Thanks again,

Bob

Lost in Translation
 

That sucks that your information got "lost in translation". :confused:
Isn't it amazing what you fiind out in those medical records, mine had all sorts of surprises (the big one being that I did have DDD and they acted like they just didn't understand why I was in soo much pain) I know my switching of doctors and starting over (for the 3rd time) is what has led me to hopefully having ADR soon :clap: Hopefully, by starting over, you can get the treatment you need in a timely manner and it will turn out to be a good thing :)
Best Wishes, Kathy

Doctor change
 

I'm kind of curious what the resonse from Aetna will be when I ask them why their expert(s) authorized payments for procedures that didn't address the correct levels.

As far as I'm concerned, Aetna is as much at fault as the last three surgeons and myself. I really should have taken control of my records and treatments a long time ago.

I hope your third doctor is the one that turns it around for you.

Bob