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Search: Posts Made By: JasonR
Forum: Insurance Hell 08-04-2009, 02:49 PM
Replies: 10
Views: 16,931
Posted By JasonR
My company got involved to get my denials...

My company got involved to get my denials reversed as we are self-insured as well. Make sure you get your HR dept as much info as possible. What really helped me was the reduced recovery time that...
Forum: New Member Introductions 07-29-2009, 10:31 AM
Replies: 8
Views: 11,242
Posted By JasonR
Katie, sorry to hear of your troubles. This site...

Katie, sorry to hear of your troubles. This site is a good resource for support and opinions. ADR seems to have excellent results, especially for us cervies, so hopefully that will enable you to...
Forum: The Big File 07-29-2009, 10:21 AM
Replies: 2
Views: 5,567
Posted By JasonR
Surgery scheduled

Had my pre-op appointments yesterday and my surgery is a go next Wednesday August 5. I'll be getting the Bryan disc. It's taken 2 years to get here but I'm hoping the Bryan disc will make the wait...
Forum: The Big File 07-29-2009, 10:13 AM
Replies: 14
Views: 13,598
Posted By JasonR
Sorry to hear about that. Losing a pet can be...

Sorry to hear about that. Losing a pet can be very tough. My daughter, who is only 7, still remembers the exact date that one of our Jack Russell Terrier's(or terrorist as the case may be) passed...
Forum: Insurance Hell 04-01-2009, 07:47 AM
Replies: 13
Views: 24,460
Posted By JasonR
Good news! I was told yesterday afternoon that...

Good news! I was told yesterday afternoon that Aetna had reversed ActiveHealth's decisions to deny the surgery. Basically ActiveHealth was NOT following Aetna's guidelines even though they are...
Forum: The Big File 03-25-2009, 04:11 PM
Replies: 6
Views: 10,844
Posted By JasonR
Good luck Bob!

Good luck Bob!
Forum: The Big File 03-10-2009, 08:16 AM
Replies: 8
Views: 13,208
Posted By JasonR
Brown, best bet is to ask your doc. My doc said...

Brown, best bet is to ask your doc. My doc said he would advise against heavy lifting for the first few months after surgery but that everything else would probably depend on how I feel. I'll be...
Forum: Insurance Hell 03-10-2009, 08:07 AM
Replies: 13
Views: 24,460
Posted By JasonR
Hmm, would they cover Germany that way? I...

Hmm, would they cover Germany that way? I alomost wonder if it would be worth it to get the newer technology. Of course, newer doesn't always mean better but I'm starting to look at an overseas...
Forum: Insurance Hell 03-09-2009, 12:36 PM
Replies: 1
Views: 85,422
Posted By JasonR
For those who have gone overseas

What would happen in the case of complications? I'm curious becuase if I do have to go overseas I'm concerned about what would happen if there were long or short term complications. I doubt my...
Forum: Insurance Hell 03-09-2009, 11:57 AM
Replies: 13
Views: 24,460
Posted By JasonR
I was surpised at first too. It's been two weeks...

I was surpised at first too. It's been two weeks now since I sent them their own policy bulletin stating they cover it and we haven't heard anything back yet. I keep hoping that it was nothing more...
Forum: Insurance Hell 02-26-2009, 09:37 PM
Replies: 13
Views: 24,460
Posted By JasonR
I'm in the same situation Bob. We're self...

I'm in the same situation Bob. We're self insured with Aetna providing ballon coverage. Not sure if that makes a difference in their policy. It is frustrating. Essentially, my employer is on hook...
Forum: Insurance Hell 02-26-2009, 08:05 AM
Replies: 13
Views: 24,460
Posted By JasonR
Hey Bob, I found that too :). Sent it along to...

Hey Bob, I found that too :). Sent it along to my HR VP and told her that IMO that's a smoking gun in our favor. They psuhed back originally saying it was still investigational. Wonder what...
Forum: Insurance Hell 02-25-2009, 05:45 PM
Replies: 13
Views: 24,460
Posted By JasonR
Need Aetna help

All, Aetna provides umbrella coverage to my company which is self insured. They have denied coverage for my ADR claiming that nobody covers that procedure currently. I've heard of Aetna covering...
Forum: Insurance Hell 02-16-2009, 08:19 PM
Replies: 39
Views: 94,334
Posted By JasonR
FWIW, Great West denied my cervical ADR a little...

FWIW, Great West denied my cervical ADR a little over a year ago. Maybe they approve lumbar ADR?
Forum: The Big File 02-16-2009, 08:13 PM
Replies: 24
Views: 29,319
Posted By JasonR
Another update

I called my doc's nurse again this morning to see if they had heard anything. She called back just as I was leaving work with some hopefully good news.

After the first appeal denial and asked my...
Forum: Insurance Hell 02-11-2009, 02:53 PM
Replies: 13
Views: 20,778
Posted By JasonR
Oddly enough that's the exact same argument I...

Oddly enough that's the exact same argument I just made to my insurance company. That nothing in my statement of benefits limited procedures based on the lack of long term data. FDA approval was...
Forum: The Big File 02-02-2009, 03:30 PM
Replies: 24
Views: 29,319
Posted By JasonR
Ok, another update. 2nd appeal denied. The...

Ok, another update. 2nd appeal denied. The reviewer, who claims to be a doctor, said that the surgery would be part of a clinical trial and therefore is experimental/investigational. What a...
Forum: Insurance Hell 01-16-2009, 02:31 PM
Replies: 2
Views: 3,860
Posted By JasonR
They denied the 1st level appeal. Safety and...

They denied the 1st level appeal. Safety and efficacy was the reason. What exactly do we have the FDA for? Left a vm for my Dr's nurse to see what the next step is.
Forum: Insurance Hell 01-13-2009, 03:04 PM
Replies: 2
Views: 3,860
Posted By JasonR
Additional info

It appears that ActiveHealth Management is owned by Aetna. I've heard that Aetna can be ADR friendly so hopefully this bodes well for the appeal(s).
Forum: Insurance Hell 01-13-2009, 02:57 PM
Replies: 2
Views: 3,860
Posted By JasonR
ActiveHealth Management

For what it's worth, ActiveHealth is the organisation that has initially denied my ADR request. The appeal info has been sent and should be received and completed this week or very early next week. ...
Forum: The Big File 01-12-2009, 08:58 AM
Replies: 9
Views: 10,798
Posted By JasonR
My surgery is scheduled for the 26th and I'm...

My surgery is scheduled for the 26th and I'm still waiting for word on my first appeal. I'm supposed to call tomorrow for an update. Personally I see my surgery being delayed at least until April. ...
Forum: The Big File 01-09-2009, 09:01 AM
Replies: 24
Views: 29,319
Posted By JasonR
Thanks Kristi. I would be in heaven if the...

Thanks Kristi. I would be in heaven if the headaches went away. I've had one nearly every day since September 1997 and it's something I've just become used to. I manage them now with 800mb of...
Forum: The Big File 01-05-2009, 09:13 AM
Replies: 24
Views: 29,319
Posted By JasonR
Insurance denied

Well, not terribly surprised but insurance denied the initial request so it's appeal time. What is surprising is that the procedure they approved was just decompression, not even fusion.
Forum: The Big File 12-12-2008, 04:23 PM
Replies: 9
Views: 13,580
Posted By JasonR
Ask your doc if he could prescribe one. Couldn't...

Ask your doc if he could prescribe one. Couldn't hurt to ask though I wonder if they would want us sleeping in that position.
Forum: The Big File 12-12-2008, 04:20 PM
Replies: 1
Views: 5,044
Posted By JasonR
Question Any correlation between injury and recovery time?

I'm wondering if there is a correlation between severity of problem pre-op and length of recovery post-op. I think it makes sense that people who have multiple levels done take longer to recover but...
Showing results 1 to 25 of 38

 

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