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Old 06-06-2005, 01:53 PM
bmills bmills is offline
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Join Date: Jan 2005
Posts: 204
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Well, received the results from the final appeal last week. Surprise surprise, the external review organization's peer doctor upheld the insurance company's denail for ADR.

Where can they find these external doctors that agree with the insurance company but no experienced doctor you see agrees that fusion is the best recommendation?

Very seriously considering a law suit. I've got what seems to be an attorney very good at these types of cases. She is researching my case this week with two chief's of surgery at two large Denver hospitals this week.

The question I am facing is; pay for the ADR or pay an attorney to file suit and possibly to take it to court if its not settled prior to that. I'm hearing that if it goes to court, it usually is in favor of the individual and not the insurance company.

There is still the option to fuse and not have to pay.

Brady
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15+ yrs chronic low back pain.
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