[Poncho]

MSO4 Man,

One of the first things I would try and do is find out who your RN Case Manager is from that insurance company. (assuming that they have RN Case Managers). IF you do not have one (yet) asked to be assigned to one. Part of their job is to do the research on your case and on ADR and help facilitate the process for approval.

IF they are unwilling to OR do not have a Case Manager to correspond with, then the only other thing i can think of is going through the appeals process.

I don't know if there on any legal people on here that deals with insurance companies - but sometimes I wonder that if a medical device is FDA approved and a physician/surgeon states that this procedure is medically necessary for a patient - On what grounds can they refuse coverage for this? - Especially knowing that ADR is FDA approved? Perhaps, I should post this question on another thread.... Hummmm....