[colorado babe]

Originally Posted by Kelly4ADR

I don't understand why they claim ADR is more money when in all actuality ADR is cheaper. Less time in the hospital 23 hours vs 4 days or so. Also, it is no longer experimental -- just show your insurer during your denial that it has been used on patients in the U.S. since 2004-2005 and it is much safer, cheaper and that in than in the future those fusion patients will be returning back most likely for another fusion. There are articles out there in the internet - use them for your appeal.

Colorado babe, it does not make sense does it...that's my point. I personally, over 8 months and 4 debates, have lost my appeal fight. There are no other options for me, unless I pay an attorney which would cost me thousands. I don't know how they can approve the surgery for some, and not others, but they do. I don't want to count your advice as useless, but I do feel you have been blessed with one of the few "lottery tickets" to be granted surgery (paid for) while some of us who are just as deserving are not afforded the same gift, and you assume it came down to your appeal...It's easy for you to say "add this or that in your appeal" as if that has anything to do with the outcome. Reason and logic has no place in this game but chance and circumstance prevail. If you were to read my 82 page final appeal, you would see I left no detail unaddressed and no room for question the logical and ethical reasons for why my surgery shouldn't be allowed. Fair? NO. Reality? YES.

I did have my congressman involved and maybe that was the reason, I don't know. It sure doesn't make sense to me but if anyone wants to use my reversal for their case, pm me and I would be happy to supply it for you. I am with Tricare but I used the Cigna case and it was very helpful.