What do you expect from insurer?
Dear Running,
You have a right to be upset. However, what did you expect? The reviewer is paid by the insurance company to deny at least part, if not all, of your claim. It's kind of ironic from what I've read on these forums that the cost of 2 ADR's would probably be less than that of one fusion. You definitely should appeal the decision. Maybe you'll get somebody with some brains to actually review it.
In the worst case, perhaps you could have one level done and pay for the second level to be done at the same time "off-label". Since you're already covered for all costs associated with one level, you won't have to pay additional for hospitalization or surgical facility fees, anesthesia, etc to pay for the second level at the same time. It will probably be less than going to Europe for 2 levels.
Gene
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Car Accident 2002 - Small Herniated Disc C3/C4
1998 Larger Herniation and Cervical Fusion C3/C4
2005 Herniation C4/C5 - 40 epidural steroid injections from Oct 2005, - Oct, 2007
2008 - Foraminotomy at C6/C7 on left side
Feb, 2010 - Cervical Fusion C4/C5
Dec, 2010 - Lumbar Fusion L3/L5
2013 - Bulge on C5/C6; herniation C6/C7 right side
Mar 26, 2013 - Foraminotomy at C6/C7 on right side
May 5, 2015 - ADR with Dr Blumenthal of TBI for C5/C6 using Mobi-C
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