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 09-25-2015, 08:52 PM
mhbussink's Avatar
mhbussink mhbussink is offline
Member
 
Join Date: Feb 2015
Posts: 32
Default Anthem BCBS denial overturned at external review

I received a letter from the IRO that reviewed my case 2 days ago. The denial for c5-c7 mobi-c disc replacement by Anthem BCBS was overturned! ! LDR patients advocacy program took care of evething for me. If anybody needs help with appealing a mobi-c disc replacement surgery LDR patient advocacy program may be able to help you get approved. It's a long process but it's worth it.
__________________
C5-C6 decompression/fusion on December, 6th,2017. C5-C6,C6-C7 mobi-c disc ADR on October 16, 2015 by Dr.Charles II. L4-L5-S1 fusion September 2013 by Dr. Charles Edwards II.
Injured back in 2002 training in the Navy Seabees.L4-L5-S1 vertebrate were showing calcification from rubbing against each other with retrolesthesis before I submitted to the fusion surgery in 2013. My neck got bad in January 2015. Moderate & severe degeneration c5-c7 w/spinal cord indentation and nerve root compression.
Reply With Quote
  #2  
Old 09-26-2015, 02:13 AM
scoop302's Avatar
scoop302 scoop302 is offline
Senior Member
 
Join Date: Oct 2012
Posts: 193
Default

Congratulations, that is good news. When are you going for surgery and where?
__________________
1979 car accident: rear ended
1980 ACDF C4-5
4/8/11 stopped, hit again
3 epidurals, PT, 2 MRI's,etc.
scheduled 3 times for C5-6, 6-7 fusion,
plus laminectomy at C3-4, and C 7, advised to do Bilateral lamino-foraminotomy C5-6, C6-7,a Percutaneous Discectomy L4 -L5
7/14 RFA on L3 to L5 (awake, local only)
C5-6,6-7 M-6 ADR with Dr. Clavel 9/17/14,
12/7/15 RFA L2-S1, Facet injections C2-7
6/3/16 RFA L2-S1, epidural L4,5, 8/26/16 RFA C1-7
Reply With Quote
  #3  
Old 09-26-2015, 10:30 AM
mhbussink's Avatar
mhbussink mhbussink is offline
Member
 
Join Date: Feb 2015
Posts: 32
Default

Thanks. DR.Charles Edwards I I at Mercy Medical Center in Baltimore MD on October 16th. Maybe sooner if there is a cancellation. 20 days to go.
__________________
C5-C6 decompression/fusion on December, 6th,2017. C5-C6,C6-C7 mobi-c disc ADR on October 16, 2015 by Dr.Charles II. L4-L5-S1 fusion September 2013 by Dr. Charles Edwards II.
Injured back in 2002 training in the Navy Seabees.L4-L5-S1 vertebrate were showing calcification from rubbing against each other with retrolesthesis before I submitted to the fusion surgery in 2013. My neck got bad in January 2015. Moderate & severe degeneration c5-c7 w/spinal cord indentation and nerve root compression.
Reply With Quote
  #4  
Old 10-08-2015, 07:51 PM
Jerry5 Jerry5 is offline
Senior Member
 
Join Date: May 2013
Posts: 363
Default Bcbs

...they are starting to realize, yes, ADR do work and yes, people are productive again, and they PAY for their PREMIUMS, while working.

Good Luck, in the neck, I would go with Mobi-C, from what I am told.
__________________
Jerry, Somewhere Ohio

L2-3 herniation, two days before Thanksgiving, 2012, Discectomy/Laminectomy, 3/13 Numbness in the right leg, lateral femoral, gone, July 10, 2014 L45 M6 ADR, July 15 PLIF L5-S1, Not able to access L51 Anterior.
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


Similar Threads
Thread Thread Starter Forum Replies Last Post
Anthem BCBS paid 100%, minus co-pay bwink23 Insurance Hell 10 09-06-2014 05:53 PM
Appeal using 'External Review' method henry4956 Insurance Hell 7 08-26-2014 11:32 AM
External review denied; lawyer? Running11 Insurance Hell 10 04-13-2013 10:41 PM
Anthem BCBS Lorraine Insurance Hell 3 05-23-2009 02:13 PM
Final appeal - External review bmills The Big File 12 06-27-2005 01:25 AM


All times are GMT -4. The time now is 10:15 AM.


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