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Insurance Hell All insurance-related matters are here: Medicare, worker's compensation, appeals, denials, insights, wins, losses. PRICING is here too. Note: This forum has posts from 2006 forward. Older ones are in the Big File. |
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Aetna
So, Looks like Aetna has a new Clinical Policy Bulletin ADR lumbar is now considered experimental and they don't cover it.
They first denied me in July as not medically necessary, now they denied it because they changed their policy in September. Said I can appeal to the California Dept of Insurance...
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Chris Back and Neck Pain 30+ years, Chiropractic care Several Epidurals and Blocks over past 5 years Awaiting Insurance for 2 ADR Lumbar L5-S1 L4-L5 Discogram showed Shredded L5-S1 5 YO MRI of neck shows straightening of cervical spine, issues at C4-5 & C5-6 and C6-7 (central disk protrusions, bilateral uncovertebral joint arthropathy, moderate neural forminal stenosis, severe central stenosis with cord compression) Aetna approved C6-7 replacement, scheduled for 11/17 |
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