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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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Hi Jason,
Aetna covered my ADR (Prodisc-C) on 03/06/09. Do you have a neurosurgeon working with you to get Aetna on board? My doc had my ADR approved from Aetna in one day. Best of luck. Like others have said, don't give up. - Michele
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2001 MVA 2003 C6-7 Herniated - 3 Epidural Blocks 2004 C6-7 Fusion 2008 C5-6 Herniated; C4-5 Bulging; 3 Epidural Blocks 2009 Prodisc-C on C5-6 03/06/09 - covered by Aetna |
#12
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Good news! I was told yesterday afternoon that Aetna had reversed ActiveHealth's decisions to deny the surgery. Basically ActiveHealth was NOT following Aetna's guidelines even though they are owned by Aetna. It's taken almost 4 months but at least it went my way.
Now if the FDA would just approve the Bryan disc. Little birdie told me that approval is probably coming within the next month.....
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DDD C5/6. Incorrectly diagnosed as tension headaches in September 1997. Nearly continuous headache since. Began having pain in wrists in 2000, believed it was onset of carpal tunnel. In 2005 pain began getting worse. Diagnosed as DDD in July 2007. Surgery recommended after 6weeks of PT made the pain worse. ADR scheduled for Jan 26, 2009. Rescheduled for August 5! Bryan disc finally FDA approved, and just in time too. Neck was all jacked up and had to be fused unfortunately. |
#13
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That is good news Jason. I'm very happy for you. Now I will be hoping that the Bryan disc gets approved, and that Aetna will also approve using that disc for you.
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Cathy MRI 12/07 L4-5 Mild-moderate disc degeneration with dessication. L5-S1 Mild disc degeneration with dessication, minimal disc bulging. PT/medication/acupuncture/ESI's/facet injection Discogram 12/3/08 confirmed L4/L5 & L5/S1 as pain generators. |
#14
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------------------------------ 4/08- DDD at C5/6 & C6/7 & bulging discs. C5/6 portrusion. 6/08- Disco results- C6/7 painful, C5/6 popping sounds 7/08- Plasma disc decompression-significant relief obtained 11/08- pain returned to almost pre surgical levels 1/09 -Disco w/ Dr Ziglar shows C5/6 & C6/7 painful-2 level ADR recommended 2/26/09 - c4-c7 ADR Prodisc Nova with Dr Bertagnoli. 100% Success but need C6/7 ADR revision due to subsidence. |
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