ADRSupport Community  

Go Back   ADRSupport Community > General Discussion > Insurance Hell

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.


Reply
 
Thread Tools
  #1  
Old 06-03-2007, 01:12 PM
Kim_Dean\'sWife Kim_Dean\'sWife is offline
Senior Member
 
Join Date: Oct 2006
Posts: 108
Default

I'm wondering if anyone knows... is there a time limit on how long insurance companies can consider a newly approved device to be "experimental?"

(I feel like I should already know the answer to this, with all of the research I've done!)
Thanks!
Kim
__________________
Wife of Dean, age 32.
Injured 12/05- snow shoveling.
Herniated Discs & DDD at
L4/5 & L5/S1.
-Chiropractic treatment
-3 Failed injections
-Orthopedic Massage
Prodisc Surgery on 2/22/07 Dr. Yue
Yale New Haven Hospital, CT
L4/L5 & L5/S1
Back
Reply With Quote
  #2  
Old 06-03-2007, 01:46 PM
LBP LBP is offline
Senior Member
 
Join Date: Aug 2005
Posts: 446
Default

This is an excellent question. Does anyone have access to Westlaw to do a little legal research on this issue. I know with my denials, the problem was "no proven long term success" meaning US published studies more than 2 years...but I don't know how many years it takes before they cant make that agrument...Technically I think the FEHB (feds ins) policy is the way to argue....once it's FDA approved you cant call it experimental and investigation.
__________________
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
Reply With Quote
  #3  
Old 06-03-2007, 02:09 PM
SeanTheFireman SeanTheFireman is offline
Member
 
Join Date: Oct 2006
Posts: 61
Default

My wife has access to Westlaw, what do you need to be looked up? The more info you can give me the better due to her not having alot of time right now because she is studying for the Bar exam
__________________
Oct 2005- Repurtured L4/L5 & L5/S1
Oct 2006 -Discogram
Hybrid Surgery Feb. 21, 2007 at New England Baptist Hospital in Boston
Charite ADR at L4/L5 and Fusion at L5/S1
Workers Comp paid 100%
Feeling Great!!
Contact me with any questions either o
Reply With Quote
  #4  
Old 06-03-2007, 07:21 PM
LBP LBP is offline
Senior Member
 
Join Date: Aug 2005
Posts: 446
Default

Sean,

I PM'd you regarding Westlaw.
__________________
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
Reply With Quote
Reply

Bookmarks

Thread Tools

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off



All times are GMT -4. The time now is 09:09 AM.


© Copyright 2006-2023 ADRSupport.org All rights reserved.