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Originally Posted by Throttlejockey
Kelly,
When we consulted with TBI- Texas Back Institute, they indicated that they were going to approach it in the same way (two-level, but insurance pays for one-level) . I got the impression that TBI works directly with LDR (the disc manufacturer) who has a outside insurance "fixer" that handles the process for them.
May want to ask your doctor. I bet his LDR Sales Rep. can provide insight.
Good Luck!
TJ
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Thanks TJ,
LDR actually handled most of my appeals to this point. MCRA is the company contracted with them who submitted a lot of documentation on my behalf. My agent at MCRA is not optimistic since they have given me so much trouble this far about the 1 level getting approval. Yet, Aetna has paid for this very surgery for other patients at my surgical center. Seems unethically and unconstitutionally random. I will try one more appeal anyway, it could save me 20k, but I'm not counting on it.
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2004 MRI -cervical bone spur causing pain
2011 MRI -5 bulging discs at C3-7: Recommended C5-6 and C6-7 for a two level fusion, I said no thanks.
2014 MRI -progressive compression C5-7.
MRI 6/5/14- Ruptured L4-5, bulge at L2-3 and L5-S1 Dr recommends discectomy of L4-5 but won't do surgery until cervical is stable
8/2014- 8 months/3 rounds of appeals, Aetna denies 2 level cervical ADR 
2 level ADR w/ mobi-c C5-7 Jan 7, 2015
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