HI again,
Well, I got a call from the California Department of Insurance and they told me our insurance would not be covered by them. The woman told me that Motion Picture is a self funded Insurance and that she could foward my book I put together to the Department of labor. Then a few days later I got a call from a very nice lady from the department of labor anf she told me that there was nothing they could do but ask Motion Picture for all the details from my denials and that different people were supposed to do each review and ask for all the material they used for their decision. I had asked for the information they based they last decision on and all they sent me was a cryptic email from Motion Picture medical director and someone at Blue Shiield. Blue Shield is our hospitalization through Motion Picture Health Plan. It did not look like there was any review just Motion Picture medical director finding out from Blue Shield that they did not want to cover it. In the mean time I got the new "Plan" from Motion Picture and now as of July 07' ADR is mentioned specifically as not being covered under this plan. I guess I am S--- out of luck! The only this I can do is sue in Federal court, or find a way to pay out of pocket, go ahead with the fusions at L5-S1 & L4-L5 leave L3-L4 alone or do nothing and live the way I am now...... sometimes not so bad. I am so confused and don't know what to do.
Abbe