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Old 08-05-2008, 04:52 PM
LBP LBP is offline
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Join Date: Aug 2005
Posts: 446
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Allan,

If I understand your post correctly, I would not mess with trying to pull one over on your ins company by paying for the ADR level and ONLY submitting a claim for the fusion level. That could be deemed insurance fraud, and if by chance something bad happens during your recovery, and they realize you have a hybrid you could be in trouble.

After being denied a 2 level Charite, I tried to submit a claim for hybrid (1 level fusion/ 1 level Charite) and I was denied the whole procedure because of the one level Charite. UHC/PacifiCare point blank said they would pay for a 2 level fusion but would not pay for anything if any part of my surgery involved an ADR. It seems ridiculous but it's a reality.
__________________
Injured 9/01
Annular tears L4/5 & L5/S1
denied adr by insurance for 2 level charite as well as hybrid fusion at L5/S1 with Charite at L4/5.

New ins paid for 2 level lumbar prodisc surgery on 4/7/08 (at age 39) with Dr. Westerlund, at Core Orthop
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