Good Job Paulette,

I think you were successful in getting your ADR paid for because you were able to put the bill in their court, and they had no legal reason not to pay your legitimate claim. All who are fighting with their insurance co. for authorization should consider this path. The ins. companies can say no all day long and as long as you listen to them and do not proceed with the surgery you and your Dr's think is a medical necessity then they win.

Read your policies and how many days planned stay in the hospital are required before pre-authorization is needed. It is usually 3 or more days. Plan your surgery and get out in 2 days and move to a hotel near buy till your first follow up. All Paulette's letters did not hurt her case, but everyone has a legal contract with their ins. co. and if you follow the terms they must also as well. This is an FDA approved procedure. It is not investigational any more as far as our Government is concerned. It does not matter if your insurance co. still think it is still unproven. If they don't pay quickly then you will have a real claim and damages that are provable. It now becomes a matter of contract law and the law is now on your side.

I hope your recovery continues to go well Paulette. Take care,

Pat