I am now in my 2nd appeal with my insurance carrier trying to get approval for ADR surgery from Dr. Blumenthal at the Texas Back Institute. Dr.Blumenthal has already approved me for one level disc replacement in the L5S1 area. I started my appeals with BCBS back in Dec.2004. Im now waiting on there response with my 2nd appeal. I have sent them hundreds of pages of documentation illustrating the need for ADR surgery i need. Dupuy Spine sent me additonal information on the Charite SB III for the insurance to review as well. Im like a lot of other people on this forum in dire need of adr surgical intervention ASAP. If anyone has had success through there appeals process, please let me know. Any information from anyone would be very appreciative on this matter. My only other option i have would be for me to take out a home equity loan and pay cash up front the adr procedure. Other BCBS insurance plans in (different states) are paying for this procedure. How can one one state w/BCBS approve this procedure and another state w/BCBS claim it experimental,investigational!. I do not understand this. A lot of pain and needless suffering that a lot of us are going through awaiting approval of insurance coverage could be avoided.
Sincerely, JF110
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