I went thru 3 appeals and got a NO at each level, all taking over the posted amount of time
(15 days posted, 30-45+ actual for each appeal) in each letter UHC / my employer sent.
I have fusion of L5-S1 scheduled for this coming tuesday.
My Doctor did say the Orthopedic Specialist for UHC called him to discuss my case in the 2nd appeal phase, My doctor said that their Doctor had obviously been retired and out of the Mainstream for about 10 years, and already had an implanted NO in his head even before discusing ADR with him. For Every 10 good points they discussed the "specialist" just focused on the 1 negative point.
Oh well, Wish me luck.... I wish all of you the best in fighting the good cause.....
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John
Greensboro, NC
DDD L5-S1
Lost all ADR Appeals w/ UHC PLIF Fusion L5-S1 on 5/17/05.
Pars Defect L3-L4
DDD L3-L4 L4-L5
3 LVL Fusion Scheduled 4/08
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