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Old 01-14-2009, 10:11 PM
Nairek Nairek is offline
Senior Member
 
Join Date: Apr 2005
Posts: 148
Unhappy Beaten By The Insurance Company.....Again

Well, I have been beaten my insurance company yet again. Looks like I will be forced into getting a fusion at L5/S1 after all.

We had hoped that my husband's insurance company might pay for ADR surgery since it was self-funded through an international company. Unfortunately the jerks said "No, it's investigational". I caught the nurse off guard when I asked her how they could say that when it's been FDA approved since August 2004. Then I got the usual BS.

My OS even took the time out to speak to the medical manager of the insurance company & they still said no. I just about lost it at work when he called me to tell me the crappy news.

Ugh! I give up. They win. I can't keep going on like this. As each day passes I am in more pain. I'm now at the point where I can't sleep on my back because I wake up with pins & needles down both of my legs.

The only other thing I can think to do is try to reach someone at the corporation medical department & see if they can try & help. But with surgery only 6 days away, I don't think I have much of an option & I hear that they aren't very fast when it comes to deadlines.

I've been told that a fusion at L5/S1 isn't that bad since there isn't much motion at that level anyway. Are there any L5/S1 fusion folks out there who can confirm this?
__________________
----Karin----
Disc Bulge C4/C5, Disc Degeneration T11/T12, Bi-Lateral tears L5/S1, Diagnosed w/ Lumbar Disc Derangement w/ Radiculopaphy. Treatment: IDET, Percutaneous Discectomy, SI Joint Injection, Facet Block. All failed. Empire BC/BS Denied Coverage for ADR-lost all of my appeals. MVP also denied coverage.

ALIF/PLIF Fusion 1/20/09

Last edited by Toebin; 01-15-2009 at 12:48 AM. Reason: language
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