Those are all very good questions. Yes, you can still appeal even if they completely deny the procedure. As Harrison mentioned, get the ball rolling immediate because the entire process can take months, and speak with the reimbursement specialists at TBI. You dont have to wait until you get the surgery to do this.
I'm sure Dr. Guyer is stellar, but if it were me, I would want to go with the absolute best. Do you know if it would be any more expensive to go with Dr. Blumenthal?
In my case, I am in the first step of the appeal process. I will be starting PT this week and as far as I know, it will be covered. Not sure about the other stuff.
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2001 - Pulled off monkey bars, landed directly on coccyx.
2006 - Sports injury that made it worse.
2016 - Multiple instances of paralyzing low-back pain.
2017 - Blew out my back on leg-press. MRI showed L5-S-1 disc herniation and grade 1 retrolisthesis.
2018 - Successful ADR surgery with Dr. Rolando Garcia using the Activ-L implant.
2019 - In physical therapy for burning in feet, L4-L5 diffuse disc bulge and SI joint pain.
2020 - Getting better with one-on-one PT.
30 - Male - American
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