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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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#21
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Best wishes to you in your upcoming procedure. Keep us posted!
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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 |
#22
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This is a classic anti-trust case fact pattern. Insurance companies or any companies conspiring/colluding in an anti competitive manner to reduce competition (e.g. choices) for consumers/patients. State and federal Attorney General's should be interested in this bad behavior. Even Medicare wrote that denying claims for all ADR surgeries would have a cooling effect on this new procedure, due to their power and influence in the medical community. This may not rise to a RICO case, because in such a case we need a criminal enterprise, and anti-competitive actions may not rise to crimes. This would be a good story for an investigative reporter (60 Minutes or Anderson Cooper....)
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#23
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D,
I am so sorry for your insurance problems. I hope you can get adequate coverage for this new proceedure you are considering. Jane
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DDD L5/S1 No Fusion, please. Looking for ADR direction 20 years of back problems, no known specific cause 5/9/07 at Consultation Texas Back Institute, Dr. Zigler 7/5/07 Insurance struggles 7/19/07 Prodisk surgery, TBI, Dr Zigler |
#24
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Update:
AxiaLIF fusion surgery is scheduled for July 23, 2007 @ 10:30 a.m. @ Northwest Surgical Hospital in OKlahoma City. This is the quickest surgery date available because the surgeon will be out of town....oh well, I can't wait any longer for the disc replacement. Like the surgeon told me, it may take months or years for the insurance co's to agree to pay a reasonable amount for the surgeons services. If I try to wait, I may be bed-fast even on the pain pills. |
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