well I had a 2 level lumbar denied by Pacificare, which was part of the PHCS network. After that, PacifiCare was bought by UHC and I was still denied a hybrid fusion/ADR.
I was told PHCS is just a network of drs and does not make actual coverage decisions. PHCS was a logo on my Pacificare health insurance card. So I'm wondering...don't you have a health ins name offering you a plan that just belongs to the PHCS network?
It was confusing because when I lived in CA everyone knew Pacificare, but when I moved to WI, no one heard of PacifiCare but when I mentioned "PHCS" they said "oh yeah we accept that" But PHCS wasn't the actual insurance company.
Maybe PHCS offers some special plan in Boston but I just wanted to clarify my experience compared to your question.
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Injured 9/01
Annular tears L4/5 & L5/S1
denied adr by insurance for 2 level charite as well as hybrid fusion at L5/S1 with Charite at L4/5.
New ins paid for 2 level lumbar prodisc surgery on 4/7/08 (at age 39) with Dr. Westerlund, at Core Orthop
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