Thread: denied
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Old 06-16-2007, 06:34 PM
LBP LBP is offline
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Join Date: Aug 2005
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Who's your surgeon? Wow that's pretty nice that's he's willing to get involved in the appeal process that way. Some offices don't do nearly that much. It might help because if you don't ask for peer to peer review, your ins company will get random non-spine surgeons to "review" your appeal. It's really insulting when you find out they had primary care, pediatric phsyicians, or even dermatologist reviewing your spine surgery request!

It wouldn't hurt to submit the federal FEHB policy, a copy of aetna's policy and Medicare's final decision too.

Good luck in the process. Hope you get a better result. Have you talked to Laurie Todd the insurance warrior yet?
__________________
Injured 9/01
Annular tears L4/5 & L5/S1
denied adr by insurance for 2 level charite as well as hybrid fusion at L5/S1 with Charite at L4/5.

New ins paid for 2 level lumbar prodisc surgery on 4/7/08 (at age 39) with Dr. Westerlund, at Core Orthop
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