Cindy,
There was a guy ESL in San Diego that discussed how he successfully got his company (self insured) to pay for his surgery. His post was on April 6, 2005. I cut and pasted one of his posts below:
earlier post from ESL:
successfully appealed to the benefits committee at my work (my employer's health plan is a self-retained plan like yours)......here are some things that helped:
1. i have been employed here 15 years and the company feels its a high likelihood that i will be here for at least another 5 years (ie, my future healthcare costs will be theres).
2. I showed them how a fusion (the alternative) would cost just as much in the short term (if not a little more), but by the time you add the additional follow on costs (ie, more drugs and care) plus the way more loss of time from work, ADR is actually cheaper than fusion!
3. I showed them some study data and european data demonstrating ADR's level of success.
Granted in one meeting!
Cindy,
I think there was some other discussion about invoving the person assigned to your case from the 3rd party administrator who takes care of the processing of your companies health insurance.
Good luck
__________________
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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