Chuck,
I called the surgeon's office asking to leave a message to speak w/him re some questions and was told his PA would call me back. She did and she didn't know the answer to any of the questions I asked so she said I could leave a message with the Research Dept and someone would get back with me. That was Wednesday afternoon.
I was just reading the 2nd non cerification I got from UR/WC and am seeing that I probably won't get anywhere with an appeal even unless Prodisc is FDA approved at the very minimum.
Wonder now whether Charite disc replacement at one level would work just as well (fusion at L5S1).. however, even tho FDA approved, am thinking this request for authorization would be shot down as well..
I've already had 2 non certifications for 2 level ADR (one with the trial and Prodisc back in '04 and one recently that wasn't even asking for authorization for surgery but rather giving an opinion and making a referral for someone that could do a 2 level ADR).
The 2nd non cert even goes on to say that fusions (other option for me)yield poor results but have been around for a much longer time (in so many words)..
For me, I believe WC is looking to settle and settle low~ getting out of authorizing surgery altogether no matter how many surgeons proposed it to date...
Ultimately, I am thinking along the very same lines as you~
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