My surgeon's office (in CA) submitted my initial request for ADR coverage last week. I was told by his office that they have been submitting ADR requests to various insurance co's for 5 months, and not one has yet been approved.
It sounds like many of us are going through this submission-denial-appeal-denial... process. I think we all believe at some point the insurance co's will agree to cover the ADR procedure (last week's Aetna clinical policy was a very positive step). However, I'm wondering if down the road when the insurance companies eventually agree to cover ADR, will they also agree to retroactively reimburse the patients whose appeals they previously denied in early 2005?
Since I probably wouldn't move forward with the procedure if I thought I would end up paying 100%, I'm debating whether to hold off until the insurance co's are paying for the procedure, or pay for it myself now and request reimbursement down the road.
Anyone had experience with this?
Thanks.
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