Community generated Insurance Appeal Letter

[APS]

Hi, I'm new here but I'm in the same boat as everyone else who has been denied ADR by their insurance for "experimental" reasons.
I've been researching fusion v. ADR to provide info in my request for independent external review (my first appeal was already denied).
Is anyone familiar with this publication: Spine Surgery: Products, Technologies, Markets & Opportunities, Worldwide. I located it at http://www.mediligence.com/rpt-m501.htm
I thought it might be worthwhile to check it out re anything helpful to argue to insurance companies.
I tried researching some medical libraries but didn't come up with any leads and unfortunately I'm 3 hours from a major city with a university medical library.
I'm so lucky to have found this forum - thanks to you all - I'm here to share and join in the cause.
Just call me,
Refuse to be fused!

[bmills]

Seveal months ago, a local denver news station did a very positive story on ADR. That was before the Charite FDA approval.

So, as I am getting tired of all the insurance denial crapp, today I sent information to the news station as well as the Tom Martino Troubleshooeter (consumer reporter).

I've asked them to please follow up with another story to cover the FDA approval and also how people are suffering by the big insurance carriers continuing to deny the FDA approved procedure.

I gave them a little background info and referenced this web site as a great place for information on how positive the true results are for ADR.

Hopefully this will get some more news coverage on the subject.

If you want to see what I sent them let me know.

Brady

[ESL]

I think it would help if this letter you all are working on was actually two letters: one for fully insured plans and one for self-retention/self-insured plans......different motivations and criteria.

[bmills]

Is anyone out there also dealing with CIGNA HMO Healthcare?

Brady

[ouch1966]

Originally posted by bmills:
[qb] Is anyone out there also dealing with CIGNA HMO Healthcare?

Brady [/qb]

I have CignaHMO in TX. I was denied a two level charite earlier this week. I have my company's insurance broker working with his "single point of contact" at Cigna to see what he can do, but I am not too optomistic. I am fortunate enough to be able to pay cash so I am working on scheduling surgey with TBI in Plano.

If Cigna comes back and approves it before I have my surgery I will switch back to the less experienced CignaHMO ortho. If not, I will check with a lawyer and see if I have grounds for an ERISA claim and try to get reimbursed.

[cavalier]

Maybe a petition of numbers of folks might make a difference to insurance cant hurt - I wonder if someone could start this petition I am REALLY short on time - Too many things in the fire right now - but would love for someone to take this link - & do this - I came across this link for someone else's cause & I had this idea -
for ADR & INSUR. to put pressure on them - get big names to sign & a ton of people numbers can move mountains -=

All the best to all - Jill ADR 7/6 /06 Dr. Bertangoli L4L5

Welcome to the Petition Site, Authentic Petitions, Real change.
http://www.ThePetitionSite.com/
Create or sign a petition in minutes. It's free, authentic and private!
ThePetitionSite.com is a service of www.care2.com, the global network for
organizations and people who Care2 make a difference!

[Nichole]

Cavalier, I would be happy to start this. I am not sure what to put on the petition though. If someone tells me what to put on the petition I will start one and start passing it around.

[andromeda1111]

F#@*ing

Dumb****s

At Large!!

They will deny anything that works as long as they do not have anything to gain by it in the first place, if they are not the ones implementing it TO BEGIN WITH, then forget it, is their philosophy, therefore...nothing can be done, getting rid of the FDA altogether is what needs to be done, only in my dreams...

They act as if they are the Gods of all law...They had come to the food plant at where I worked, and I gave them a hard time, I would not grant them access, (I am security there) they said they never in 15 yrs had anyone deny them entrance. I smirked at them, made them wait at the gate until I felt like letting them in. I enjoyed that!!
Laura

[biffnoble]

Blue Cross and Blue Shield of Florida.

Subject: Artificial Intervertebral Discs


http://www.bcbsfl.com/MCG/index.cfm?...10264#P27_1902