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
  #11  
Old 11-30-2005, 10:45 AM
Judy Judy is offline
Senior Member
 
Join Date: Nov 2004
Posts: 194
Default

Hi Laura, I would greatly appreciate asnything you can send me on your appeal process. I am currently in the process of appealing Cigna Healthcare for my surgery.

Thank you in advance for your help.

Judy
__________________
Surgery Vienna by Dr. Bertagnoli Oct. 16, 2004
ADR L3/4
Fusion L4/5
ADR L5/S1
Diagnosed with Arachnoiditis 11/06
Reply With Quote
  #12  
Old 12-02-2005, 05:55 PM
ans ans is offline
Senior Member
 
Join Date: Mar 2005
Posts: 1,596
Default

Laura: You kicked butt in your perserverance. Also, I wish you the best for your surgery. Finally, thank you for helping others obtain approvals as a result of your v. hard work. - Allan
__________________
Severe, extensive DDD, considered inoperable by Dr. Regan, Lauressen, & some guy at UCLA. Severe foraminal stenosis (guess they can't operate!) and some spinal cord compression that Lauryssen would fix if gets outta hand.
Reply With Quote
  #13  
Old 09-01-2006, 12:22 PM
dan dan is offline
Junior Member
 
Join Date: Sep 2006
Posts: 5
Default

Hi. I just receivd a letter of non-certification from my insurance company, Blue Cross. I need a disc replacement at L5. Rick Delamater is slated to perform the surgery (using a ProDisc) on October 5. I would be greatly appreciative if anybody has any thoughts or suggestions as to to the viability of appealing the BC denial.

Alternatively, my wife has Great-West availble to her--does anybody know if they cover this surgery?

Lastly, if Great West doesn't, and my BC appeal is not fruitful, I am starting a new job in January and will be able to choose from many insurance companies--which ones cover this procedure?

Thank you in advance.

dan lowenthal
long beach, ca
__________________
dan lowenthal
Reply With Quote
  #14  
Old 09-01-2006, 01:00 PM
David David is offline
Senior Member
 
Join Date: Mar 2005
Posts: 455
Default

Not that this helps, but, to my knowledge, you are the first person to receive a denial for U.S. Prodisc (that I have heard of)

David
__________________
47 years old
Surgery: 14-NOV-2006; Straubing, Germany (Dr. B.)
L4-S1: Prodisc
Reply With Quote
  #15  
Old 09-01-2006, 05:07 PM
dan dan is offline
Junior Member
 
Join Date: Sep 2006
Posts: 5
Default

You mean companies are approving ProDisc right now? If so, which companies? Rather than enter into a protracted battle with Blue Cross, I'd like to just sign-up with a company that will do the right thing.
__________________
dan lowenthal
Reply With Quote
  #16  
Old 09-01-2006, 05:19 PM
David David is offline
Senior Member
 
Join Date: Mar 2005
Posts: 455
Default

What I mean to say is that Prodisc was FDA approved about two weeks ago, I seriously doubt that any insurance company will cover Prodisc surgery for quite awhile.

(ie, you are the first person to post that has asked for Prodisc coverage. I plan on waiting until mid-October to ask for my Prodisc denial)

Charite was FDA approved in 2004, and many insurance companies continue to deny people for that a particular device.

David
__________________
47 years old
Surgery: 14-NOV-2006; Straubing, Germany (Dr. B.)
L4-S1: Prodisc
Reply With Quote
  #17  
Old 09-01-2006, 06:56 PM
jf110 jf110 is offline
Member
 
Join Date: Mar 2005
Posts: 93
Default

Laura,
Congratulations to you on your approval. I went through three appeals back last year when i finally got my approval for ADR surgery at the Texas Back Institute. My insurance was BCBS also. I am glad you stuck with and won. Mark
Reply With Quote
  #18  
Old 09-02-2006, 08:10 AM
Mariaa Mariaa is offline
Banned
 
Join Date: Nov 2004
Posts: 1,121
Default

Laura,
Have you had surgery yet? If so, how are you doing?
Reply With Quote
  #19  
Old 09-02-2006, 08:13 AM
Mariaa Mariaa is offline
Banned
 
Join Date: Nov 2004
Posts: 1,121
Default

Dan ~ are you in Long Beach? So am I..
Reply With Quote
  #20  
Old 09-02-2006, 10:31 AM
dan dan is offline
Junior Member
 
Join Date: Sep 2006
Posts: 5
Default

Yes, I am in Long Beach--my family lives in the Rose Park area. My local physician in Eric Feldman--he referred me to Delamarter.
__________________
dan lowenthal
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
Anyone approved by UHC? Paul Insurance Hell 21 05-13-2011 12:04 AM
Surgery Approved! 5/17 is the big day! Texas-T The Big File 4 05-05-2006 05:09 PM
Tell us if your insurance has approved ADR kristi The Big File 5 02-09-2006 06:44 PM
To those who have been approved... Drew The Big File 5 07-21-2005 07:01 PM


All times are GMT -4. The time now is 12:59 AM.


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