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| The Big File All issues not easily categorized in the above forums are here. Comments on general health, diet, "getting comfortable," and more are here. |
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#1
10-02-2005, 02:02 PM
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Harrison,
So many posts ask who has been successful in obtaining adr insurance coverage, I think a database of specifics would be quite beneficial to those still caught in the battle. You could set it up similar to your ADR Surgical Outcomes with name, insurance company, surgery, date, Dr., hospital, exclusions/limitations, etc. This information could then be cut and pasted by interested parties, set up as a database, sorted by their specifics and used in appeals. You wouldn't need a new forum, only a topic within the Big Bucket. It would also reveal the ambiguous criteria insurance utilize in their decision making processes, something that could be used to involve insurance commissions. Dale 
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#2
10-02-2005, 02:07 PM
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Dale,
I like your reference to the insurance companies "ambiguous criteria". Aside from just insurance others are dealing with medicare and workers' compensation. We'll see if a call goes out to assist with more organizational duties.
__________________
Crystal L5/SI Charite 7/18/05 Dr. Howard http://www.myspace.com/luvmysibe http://www.xanga.com/luvmysibe "A smile is contagious, be a carrier  ."
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#3
10-04-2005, 02:23 AM
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Does anyone have Insurance United Health Care PPO and if so do they approve of the Chartie procedure?
---------------------------------------------- L3-L4 Moderate disc degeneration-A posterior fissure is present. A 4 mm central disc protrusion is noted. Mild hypertrophy of the facet joints. Mild spinal stenosis present, L4-L5 Severe disc degeneration-A posterior fissure is present. Right paracentral posterior measuring 5 mm. Moderate hypertrophy of the facet joints. Mild spinal stenosis present. L5-S1 Mild disc degeneration-A right posterolateral fissure is present. Mild 2 mm posterior disc bulge.
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#4
10-04-2005, 10:09 AM
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I have UHC PPO. I received my Kineflex disc in the Kineflex/Charite study. My doctor submitted all the insurance claims and appeals. In the end, UHC paid a percentage of my surgery: surgery center, anesthesiology, pre- and post-op x-rays, and misc other procedures. They refused to pay for either surgeon, claiming it was experimental surgery and there was no proof it would be beneficial in my situation. Because I'm part of the study, they didn't pay for the disc. The study paid what insurance did not.
Mars L5-S1 Kineflex ADR 7/19/05
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