[Kelly4ADR]

Still waiting to hear from Aetna regarding the first appeal that my surgeon sent. Although they did send me a postcard stating that they received it and will be reviewing it. I did, however, contact my spine clinic and asked them what's next if Aetna denies the appeal. She gave me the number to a business in CA that deals with appeal help, so I called there and left a message. The next day I got a call from my spine clinic. Apparently the rep from the business in CA that she referred me to doesn't help patients, only businesses. The rep called her and told her to have me stop calling. then she said they were contacting LDR to see who could help me. An LDR rep gave them a number for me to call... The LDR reimbursement and appeals dept. (LDR makes mobi-c, the cervical device I am waiting for). Of course they have a dept such as this, they want to sell their product. so, I called them! And... She wouldn't talk with me because they have to work through the surgeons office. So... I called the spine clinic back, and asked her to send the release to me so I could sign so she could talk with them. She sent the release and I called LDR back and she talked to me this time, explaining if Aetna denies the request that has been submitted, then LDR can send an appeal on behalf of my surgeon. If that is denied then they will send one on my behalf. They already have an appeal packet ready to go. I would just plug in my personal info and sign. This is a relief to know since I have already started an appeal and it is very taxing. It is a lot of info to try to gather and organize. I know it seems as if I'm talking a lot about nothing, but maybe these two things can be helpful to someone:

1) If you need to appeal your insurance decision, call the company of the prosthetic you are seeking. They can probably help you.

2) if at first you don't succeed, try...try (or call...call ) again. We are our best advocates.