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Forum: Insurance Hell 11-13-2008, 05:34 PM
Replies: 2
Views: 1,743
Posted By mmarsh
Question Time for choosing insurance company

Hello all- Hope things are okay for you. Could you please give me any names of ins cos that are covering ADR. It's time to pick my carrier and BCBS is not amenable to ADR. Appreciate any info you...
Forum: New Member Introductions 06-22-2008, 06:46 PM
Replies: 12
Views: 7,800
Posted By mmarsh
Billy Welcome to the forum, sorry you need...

Billy

Welcome to the forum, sorry you need to be here. Best of luck to you in your surgery. Just remember to take it slowly no matter how good you may feel afterward.

Missy
Forum: Insurance Hell 06-02-2008, 10:15 PM
Replies: 19
Views: 7,006
Posted By mmarsh
LBP Sad that things have changed so little...

LBP

Sad that things have changed so little over the years isn't it? It's too bad these docs don't keep up with the latest technology after they leave practice and then decide that something is...
Forum: Insurance Hell 06-02-2008, 05:14 PM
Replies: 19
Views: 7,006
Posted By mmarsh
Janey Thanks for the hugs! I really needed...

Janey

Thanks for the hugs! I really needed them!

Sahuaro

I'm thinking that my docs were equally unimpressed or didn't really read what I wrote. I'll keep you posted.

Missy
Forum: Insurance Hell 06-02-2008, 05:12 PM
Replies: 19
Views: 7,006
Posted By mmarsh
Rich It was the independent hearing. It was...

Rich

It was the independent hearing. It was to the CA state dept of ins, they call it an independent medical review. I have not seen the denials yet, they are in the mail, but apparently the 3...
Forum: Insurance Hell 06-02-2008, 11:31 AM
Replies: 19
Views: 7,006
Posted By mmarsh
Well got a call from the state dept of ins and...

Well got a call from the state dept of ins and they agree with the ins co that ADR is experimental! I guess all you recipients and your docs are bucking the powers that be! You're all so lucky that...
Forum: Insurance Hell 05-31-2008, 01:06 PM
Replies: 7
Views: 2,656
Posted By mmarsh
April Contact the manufacturer of the disc...

April

Contact the manufacturer of the disc your surgeon wants to use and ask them which companies are covering the use of their disc. They have some basic info that you can use. Find any and all...
Forum: Insurance Hell 05-22-2008, 01:31 PM
Replies: 3
Views: 2,393
Posted By mmarsh
April My best advice is to buy Laurie Todd's...

April

My best advice is to buy Laurie Todd's book. The insurance warrior is what she calls herself. You can only find it on-line. There's a thread about her here somewhere. She has wonderful...
Forum: Insurance Hell 05-20-2008, 12:47 PM
Replies: 11
Views: 4,661
Posted By mmarsh
Other than my spine, I'm the healthiest 51 year...

Other than my spine, I'm the healthiest 51 year old I know! I walk at least 2 miles every day, work out for 1 1/2 hours 3 days a week, play golf 1-2 a week (All of this when healthy, now I'm only...
Forum: Insurance Hell 05-19-2008, 08:04 PM
Replies: 11
Views: 4,661
Posted By mmarsh
Congrats to you fixitright! I hope I get someone...

Congrats to you fixitright! I hope I get someone who has the ability to think at the state agency. It seems so simple to me that a procedure that costs over $50K less and has a very positive...
Forum: Insurance Hell 05-12-2008, 11:32 AM
Replies: 19
Views: 4,801
Posted By mmarsh
Terry Thanks for the good words! Is there...

Terry

Thanks for the good words! Is there anyone with a brain working at these ins offices? My surgeon wants to do ADR which will cost $22K and they want me to get another fusion which costs...
Forum: Insurance Hell 05-08-2008, 11:30 AM
Replies: 19
Views: 4,801
Posted By mmarsh
Phylly Do you have an HMO or PPO? Did you...

Phylly

Do you have an HMO or PPO? Did you file with the DMHC like Kimmers? Apparently, the DOI (Dept of Ins) is for PPO's and the DMHC is for HMO's. My attorney told me that the DMHC is...
Forum: Insurance Hell 05-06-2008, 05:32 PM
Replies: 6
Views: 3,310
Posted By mmarsh
Jayne If you get anything I'd surely like...

Jayne

If you get anything I'd surely like copies for myself. They are very difficult to find, as you've discovered. Wish I had something for you, but am on the same quest. Good luck to us both!...
Forum: Insurance Hell 05-06-2008, 05:30 PM
Replies: 11
Views: 4,661
Posted By mmarsh
If anyone has had success in getting a state...

If anyone has had success in getting a state agency to overturn their ins co, I'd surely like to see what you have. BS of CA has denied me again and so now I'm off to the Dept of Ins, state of CA. ...
Forum: Insurance Hell 05-04-2008, 02:07 PM
Replies: 2
Views: 1,991
Posted By mmarsh
Sherry Call the ProDisc hotline, you can...

Sherry

Call the ProDisc hotline, you can find the number on the Synthes website. They can tell you who is authorizing ADR. There are some BCBS companies that are okaying them. Good luck.
Forum: Insurance Hell 04-28-2008, 05:27 PM
Replies: 60
Views: 20,857
Posted By mmarsh
Janey I checked my notes and Cigna is...

Janey

I checked my notes and Cigna is authorizing Prodisc. Look at the Synthes web site and you will find a number for patient support. Call them and get info regarding Cigna's authorization. ...
Forum: Insurance Hell 04-14-2008, 04:22 PM
Replies: 19
Views: 4,801
Posted By mmarsh
To all: spoke to a representative at my...

To all: spoke to a representative at my insurance broker's office and she said if I go ahead with an "unauthorized" procedure, the ins co is NOT liable to cover any expenses. I've decided that this...
Forum: Insurance Hell 04-13-2008, 04:54 PM
Replies: 19
Views: 4,801
Posted By mmarsh
Liz It looks like the DMHC never overturns...

Liz

It looks like the DMHC never overturns anything! What is that about? Thanks for info.

M
Forum: Insurance Hell 04-13-2008, 01:06 PM
Replies: 19
Views: 4,801
Posted By mmarsh
Liz Thanks for the info. I was thinking...

Liz

Thanks for the info. I was thinking that cosmetic surgery was the perfect example. Did you speak to anyone specific at the state level? Who at your ins co did you speak with?

M-
Forum: Insurance Hell 04-11-2008, 10:42 PM
Replies: 19
Views: 4,801
Posted By mmarsh
I have a question and I'm not sure if anyone...

I have a question and I'm not sure if anyone knows the answer. Help out if you can, please. If I pay for my ADR out of pocket, what responsibility does the ins co have after the surgery? Let's say...
Forum: Insurance Hell 04-01-2008, 01:13 PM
Replies: 15
Views: 3,614
Posted By mmarsh
Has this idea gotten anywhere? Been a while...

Has this idea gotten anywhere? Been a while since any posts. Let me know I'm interested for my own appeal.

Missy
Forum: Insurance Hell 04-01-2008, 12:56 PM
Replies: 6
Views: 3,638
Posted By mmarsh
Mr D Sure hope your surgery went well. When...

Mr D

Sure hope your surgery went well. When you're feeling up to it could you share your info? I could use it for my appeal. Need surgery date, location and ins co. YOur name is helpful but...
Forum: Insurance Hell 04-01-2008, 12:53 PM
Replies: 4
Views: 3,175
Posted By mmarsh
I'm appealing also. Sorry I can't help yet. As...

I'm appealing also. Sorry I can't help yet. As soon as I'm approved you'll be informed and can use my info at will!

Missy
Forum: Insurance Hell 04-01-2008, 12:49 PM
Replies: 9
Views: 5,676
Posted By mmarsh
MGS Hope all went well and by now you're...

MGS

Hope all went well and by now you're feeling good. If you could give me some info for my appeal I'd appreciate it. Your surgery date, location and ins co name. Your name or initials would...
Forum: Insurance Hell 03-27-2008, 12:10 PM
Replies: 8
Views: 2,560
Posted By mmarsh
Sam Please send anything you have. I'm...

Sam

Please send anything you have. I'm appealing BS of CA, but any "precedent" is helpful.

Missy
mdm798@aol.com
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