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Showing results 1 to 25 of 26 Search took 0.01 seconds. Search: Posts Made By: ESL

Forum: The Big File 05-13-2005, 12:37 AM

Replies: 14 Hello Views: 10,365 Posted By ESL JoJo Welcome....i hope you can find some... JoJo Welcome....i hope you can find some answers and some comfort here like i did......For me the best part was putting faces to the statistics......I even had one fellow member visit me in the...

Forum: The Big File 04-21-2005, 11:15 PM

Replies: 22 Behavior on this forum Views: 15,863 Posted By ESL Laura....you kill me!!!! Laura....you kill me!!!!

Forum: The Big File 04-21-2005, 07:04 PM

Replies: 7 starting the insurance process Views: 10,114 Posted By ESL sf.....somebody on this board posted a few days... sf.....somebody on this board posted a few days ago that some doctor in Texas was the most prolific ADR doc in the US....now you say its Dr. McAfee.......there really is only one right...

Forum: The Big File 04-18-2005, 07:10 PM

Replies: 93 Did your insurance pay? Let's help one another Views: 88,060 Posted By ESL kim having gone thru what you just did last... kim having gone thru what you just did last year, i might be able to help you.....leave me an email or phone number....I will reach out to you.

Forum: The Big File 04-18-2005, 06:37 PM

Replies: 93 Did your insurance pay? Let's help one another Views: 88,060 Posted By ESL did they tell you the grounds for the... did they tell you the grounds for the denial...tha would be a good place to start.

Forum: The Big File 04-16-2005, 07:15 PM

Replies: 7 I'm loosing my mind with this 'code' thing, help me understand this Views: 13,404 Posted By ESL those codes are new so if you doctor does not... those codes are new so if you doctor does not have the latest set of codes he will not have those.....I am getting those codes done at a top notch hospital in santa monica.....pretty durned sure...

Forum: The Big File 04-16-2005, 03:47 PM

Replies: 7 I'm loosing my mind with this 'code' thing, help me understand this Views: 13,404 Posted By ESL here is what i wrote to someone else about... here is what i wrote to someone else about codes.....its on a pre-auth i have for my 2 disc procedure in 12 days. I have 3 codes on my pre-authorization: 63090 63091 and 22851

Forum: The Big File 04-15-2005, 06:33 PM

Replies: 10 CPT code Views: 15,409 Posted By ESL there was one person on this board working thru... there was one person on this board working thru tricare (kinda unsuccessfully so far)....search for "military" and i am sure those threads pop up.

Forum: The Big File 04-13-2005, 06:04 PM

Replies: 8 Insurance for 2 or 3 level Views: 6,796 Posted By ESL I have an approval for my impending 2 level... I have an approval for my impending 2 level prodisc procedure....

Forum: The Big File 04-13-2005, 04:36 PM

Replies: 93 Did your insurance pay? Let's help one another Views: 88,060 Posted By ESL I think what NC-ADR meant to say was if your... I think what NC-ADR meant to say was if your company is "self-retained or self-insured" not "fully insured" only the company can dictate changes or exceptions to coverage........ My pre-auth does...

Forum: The Big File 04-13-2005, 12:06 PM

Replies: 93 Did your insurance pay? Let's help one another Views: 88,060 Posted By ESL I have 3 codes on my pre-authorization: ... I have 3 codes on my pre-authorization: 63090 63091 and 22851 and you are right Juli.....your HR manager or benefits manager should be able to tell you whether your company (your hubby's...

Forum: The Big File 04-09-2005, 03:58 PM

Replies: 93 Did your insurance pay? Let's help one another Views: 88,060 Posted By ESL Paulette are you part of a self-insured plan thru... Paulette are you part of a self-insured plan thru your employer? My employer is self-insured with healthcomp as the third party administrator....their case management people are top notch.

Forum: The Big File 04-07-2005, 05:55 PM

Replies: 8 Insurance won't cover ADR!!!!! HELP..... Views: 7,272 Posted By ESL MM the closed study ....is it truly closed... MM the closed study ....is it truly closed or is the initial phased closed....sometimes they have these continued access phases where there is no more randomaization (meaning you have a 1 in 3...

Forum: The Big File 04-06-2005, 02:23 PM

Replies: 35 back to full duty...? Views: 43,045 Posted By ESL Pablo Maybe you need to find a job working... Pablo Maybe you need to find a job working for one of those construction inspection and testing companies.....you know, the guys hired by cities and developers to inspect the contract and asphalt...

Forum: The Big File 04-06-2005, 02:21 PM

Replies: 3 ADR Coverage Denied Need Help Please! Views: 4,637 Posted By ESL I just sent you an email .... I just sent you an email ....

Forum: The Big File 04-06-2005, 01:56 PM

Replies: 3 ADR Coverage Denied Need Help Please! Views: 4,637 Posted By ESL Kim I gave you an answer that might be very... Kim I gave you an answer that might be very helpful to you on the other thread.....

Forum: The Big File 04-06-2005, 01:51 PM

Replies: 4 ADR insurance has denied need help with appeal please Views: 7,353 Posted By ESL Kim I successfully appealed to the benefits... Kim I successfully appealed to the benefits committee at my work (my employer's health plan is a self-retained plan like yours)......here are some things that helped: 1. i have been employed...

Forum: The Big File 04-06-2005, 01:36 AM

Replies: 8 Insurance won't cover ADR!!!!! HELP..... Views: 7,272 Posted By ESL Also, remember that you (Morphineman) are not... Also, remember that you (Morphineman) are not limited to a Charite implant.....there are at least three others that are in the FDA study phase (Prodisc, Maverick and Flexicore)....and at least one of...

Forum: The Big File 04-02-2005, 10:34 AM

Replies: 12 Hiding Harrison Views: 10,436 Posted By ESL Injections never worked for me......I ended... Injections never worked for me......I ended having them shaving 1 inch of excess bone off my acromium bone (the shoulder bone).....the extra lenght of bone was peeling my rotator cuff everytime i...

Forum: The Big File 03-31-2005, 01:38 PM

Replies: 18 insur. co won't pay for ADR & I'm running out of time Views: 19,376 Posted By ESL I have a pre-approval cert from my insurance... I have a pre-approval cert from my insurance company that lists the following codes: Diagnosis: 722.83 Procedure: 63090 63091 22851

Forum: The Big File 03-30-2005, 10:15 AM

Replies: 93 Did your insurance pay? Let's help one another Views: 88,060 Posted By ESL i have posted this several times on many parts of... i have posted this several times on many parts of this board, but no one seems to really notice....however it is a very important nuance wiht regard to the willingness of insurance companies to...

Forum: The Big File 03-27-2005, 11:39 PM

Replies: 12 Blatant Advertising Views: 13,126 Posted By ESL The people on this site do have their favorite... The people on this site do have their favorite service providers and do have strong opinions with respect to ADR....I personally am outside of their sphere of preferences (my ADR being done in Santa...

Forum: The Big File 03-25-2005, 07:19 PM

Replies: 5 2nd Appeal Denied - UHC Views: 8,326 Posted By ESL John It took 1 year but its because our... John It took 1 year but its because our benefits manager from early in the process did not understand all this stuff (ie, the appeals process for a self-retention plan). after i was denied the...

Forum: The Big File 03-25-2005, 02:19 PM

Replies: 38 Community generated Insurance Appeal Letter Views: 34,946 Posted By ESL I think it would help if this letter you all are... I think it would help if this letter you all are working on was actually two letters: one for fully insured plans and one for self-retention/self-insured plans......different motivations and...

Forum: The Big File 03-25-2005, 01:23 PM

Replies: 5 2nd Appeal Denied - UHC Views: 8,326 Posted By ESL John I went thru an appeals process to my... John I went thru an appeals process to my company's benefits commitee and was successful....the reason that you had issues with your "insurance provider" (basicall the 3rd party administrator for...

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