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Old 09-13-2005, 01:21 AM
cervie queen cervie  queen is offline
Senior Member
Join Date: Jun 1998
Posts: 264

I'm searching for answers here to my cancelled surgery. I'm not being even given a reason. The guy at Cedars Sinai hasn't returned my calls. Here's what I get at Medicare: "We don't pre-approve." Well, if you don't pre-approve how will I know if it's covered? "We covery surgery if it's Medically Necessary." Well, I can breathe and walk shnort distances...."Well, your doctor has to deem that it's medically Necessary." Well, OK, I guess he'll state that. "And the #2 criteria is that it is reasonable" Well it' shouldn't cost $1 million for a wheelchair. Where do I find a list of the devices that are prohibited or as the only other reason, unreasonable? I'll have to call my supervisor on that and call you back. Right. Absolutely zero answers. How can I fight what I don't know. I am only assuming that Medicare won't pay for my Bone Morophogenic protein for the fusion nor will they pay for the dynesis, but the denial came from the HOSPITAL, not Medicare of the Doctor.
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