Stan, and anyone in the Appeals Vortex:
I fit the FDA guidelines as well as could be, but still was denied coverage -- just once so far. I have written to the insurance company and await a response. I'm 37, very fit, pain for years, tried multi other treatments, but disc space is about gone for L5-S1. Other discs look great on MRI. Reason for denial was basically "lack of information on procedure", and not fitting the policy's definition of "medical necessity". Both reasons are total BS.
My appeal letter is a bit long and dramatic, but I actually feel it might make a difference...maybe. If anyone thinks they might get ideas from it to use in their appeals, let me know and I'll post the text.
Keep the pressure on, it will work.
Dave
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