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Old 10-29-2017, 04:20 PM
ia75 ia75 is offline
Junior Member
Join Date: Oct 2017
Posts: 16
Default Still waiting

Originally Posted by Tatonka_usn View Post
As someone with BCBS FEP, I'm in the same boat. If you receive any feedback, would you be willing to pass it along...since I'm considering Europe vice dealing with FEHB at this point
Hello, Tatonka_usn,
sorry for the late reply, I've been all over the place lately. My surgeon in Miami all but abandoned me after the initial denial, so I ended up retaining an attorney. I am still trying to get an urgent appeal processed but I am not really sure if that will do anything. I am from Florida, which state are you in? I contacted my senator here after BCBS kept stone-walling me and brushing me off. He asked me to sign a consent form because of HIPAA, no idea if this will make a different...for what it's worth, I am not going down without a fight!

I just got evaluated by Dr. Bergatloni in Berlin, Germany. He is supposed to be one of the best but also pricey: for a one-level ADR, I got a price estimate for $32,000 Euros. I am still waiting for the evaluation from Dr. Dasai (Cologne, Germany). He also has a good reputation. I heard that the Texas Back Institute may offer cash-prices as well...

I am so confused in terms of what device is best: I was initially going for the activL (that's the one the surgeon in Miami uses), TBI I believe does the ProdiscL, and Dr. Dasai uses the LP-ESP...

What is your status/plan?
42 y.o. female, athletic build, otherwise healthy
L5-SI: Severe DDD with subtotal disc collapse, mild to moderate bil. foraminal stenosis.
2007: car accident, mild herniation, intermittent pain.
2012-17: pain chronic, progressive, resistant to conventional treatment.
06/2017: Discogram, MRI
10/04/2017: ADR surgery denied by BCBS (FEP),

Pain is severe and disabling
04/04/2018: ADR surgery using LP-ESP disc with Dr. Desai
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