[cruiser]

Could you outline your appeal, just list the items you used in the appeal.

-I used "Google Scholar" and regular google to parse through vast
numbers of medical journals, articles, white papers, research papers, opinions by neurosurgeons and orthopedic surgeons. I put together a cover letter, table of contents, an about 40 pages of documents that I had printed at Office Max and bound with a cover. All pertained to the benefits of multilevel ADR's and opposition to fusion.

Procedures, Medicine, length of pain, other therapies tried...?

-I tried various meds for relief, they just masked the pain. I have had issues with the deterioration of the discs as my C5-6 and C 6-7 started contacting each other. ie. severe foraminal stenosis, and central cord
stenosis.

Did you get Pre-Authorization?

-I tried and was denied due to arcane FDA regs and my policy. However when I learned that the insurance Co, would pay to have my entire cervical spine fused into a solid block of bone that gave me impetus to fight.

Was your Treatment plan more than one level, 'for Pre-Authorization?

-No. Not for ADR. But BCBS would gladly pay for a hybrid-construct of total fusion. ( Note: I already have a C 3-4-5 fusion )

What percent did they pay, was this negotiated at all?

- I got 100% coverage minus a small copay. I did foot the entire cost of the plane tickets for myself and my beautiful companion.

(If you would like, send private)

Sorry for all the questions.

How long ago was this and how are you doing?

- I had the operation in September of 2013. I am well except for some residual nerve damage that was affecting my right arm and shoulder before the operation. I am hoping that time and exercise will help. I have had no issues at all with the M6-C's, the operation, or the incision.


-Regards !! "Cruiser"