Kim
I successfully appealed to the benefits committee at my work (my employer's health plan is a self-retained plan like yours)......here are some things that helped:
1. i have been employed here 15 years and the company feels its a high likelihood that i will be here for at least another 5 years (ie, my future healthcare costs will be theres).
2. I showed them how a fusion (the alternative) would cost just as much in the short term (if not a little more), but by the time you add the additional follow on costs (ie, more drugs and care) plus the way more loss of time from work, ADR is actually cheaper than fusion!
3. I showed them some study data and european data demonstrating ADR's level of success.
Granted in one meeting!
email me at
eliu@san.rr.com if you wish to get more details. if you give me a phone number, I would be happy to call you to discuss.
Good luck.