Dear friends,
I am stinking mad. Friday I just got my external report that denied a 2 level ADR at C 4-5 and C 5-6. I live in CA but have Blue Cross/ Blue Shield of Ohio.
The report said I could get a fusion/ADR at level C 5-6 but not at C 4-5.
I have 2 MRI's, CT-scan, EMG/NG, and Discogram that all conclude that C5 and C8 and L5 nerve roots are blocked. They all state that I have cervical stenosis at C 4-5 and C 5-6.
The reviewer denied ANY treatment at C 4-5 based on the fact that I don't have stenosis at that level. The knucklehead also stated that just because something is FDA approved and your 6 spinal doctors say you need treatment doesn't mean you do.
Say what? The reviewer never examined me nor got a copy of any discs or images. How could he deny my medical testings findings? Was he on crack? Was he reading the wrong report?
What are my means of recourse if any? He sounds very incompetent. I am stinking mad and will keep fighting .
What can I do , if anything. Thanks for being so supportive.