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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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#11
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when you say "mandate" do you actually have a copy of the FEHB policy letter?
You can find it online. Us Office of Personnel Management, Office of Insurance Programs, FEHB Program Carrier Letter (All Carriers) Letter No. 2001-27. It's not a case by case policy. That was the whole point of making the policy. Carriers were being inconsistent in applying their own standards vs FDA standards of what is "experimental and investigational." look up the "mandate" read the policy letter! Being a federal employee, you have a stronger argument than most. There is a guy a long time ago that won this argument when his private insurer denied him, against Fed policy. He got is surgery. do a "find" for FEHB you'll probably find him.
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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 |
#12
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I'd be more than grateful to see an approval letter from Anthem BC of CA and Empire BC/BS of NY. Puleeze!
ans bicyclettes@yahoo.com
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Severe, extensive DDD, considered inoperable by Dr. Regan, Lauressen, & some guy at UCLA. Severe foraminal stenosis (guess they can't operate!) and some spinal cord compression that Lauryssen would fix if gets outta hand. |
#13
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Hello,
I would appreciate a copy of this letter also. If anyone else on the board has any approvals from BC BS I would be greatly appreciative. Thanks Jim
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Hybrid surgery performed by Dr Clavel Nov. 2012 Adr- S1-L5 with M6 Fusion- L5-L4 Adr- L4-L3 with M6 |
#14
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Sorry you can send it to mygirls@twcny.rr.com
Thanks again
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Hybrid surgery performed by Dr Clavel Nov. 2012 Adr- S1-L5 with M6 Fusion- L5-L4 Adr- L4-L3 with M6 |
#15
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I'm waiting!
The check w/be in the mail.
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Severe, extensive DDD, considered inoperable by Dr. Regan, Lauressen, & some guy at UCLA. Severe foraminal stenosis (guess they can't operate!) and some spinal cord compression that Lauryssen would fix if gets outta hand. |
#16
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Quote:
Terry Newton
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1980 ruptured L4-L5 1988 ruptured SI-L5 1990 ruptured C5-C6 1994 ruptured C6-C7 1995 Hemi-Laminectomy C5-C6, C6-C7 Mayo Clinic Bicycle Accident 2004 MRI, EMG, Facet Injections, Epidural Blocks, Lumbar Discogram. Stenum Hospital Surgery November 4, 2006 Prestige Disc C5-C6, C6-C7 Maverick Disc S1-L5, L4-L5 |
#17
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Quote:
Terry Newton </div></BLOCKQUOTE>
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1980 ruptured L4-L5 1988 ruptured SI-L5 1990 ruptured C5-C6 1994 ruptured C6-C7 1995 Hemi-Laminectomy C5-C6, C6-C7 Mayo Clinic Bicycle Accident 2004 MRI, EMG, Facet Injections, Epidural Blocks, Lumbar Discogram. Stenum Hospital Surgery November 4, 2006 Prestige Disc C5-C6, C6-C7 Maverick Disc S1-L5, L4-L5 |
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