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| 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. |
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#1
12-29-2008, 03:12 PM
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getting reimbursed AFTER surgery. possible?
Hi all,
Una pregunta mas.. It now looks like I am going to proceed with Dr. Delamarter. I have UnitedHealthCare and will have to fight, possibly through multiple appeals. But I don't want to wait. My family can help me pay out of pocket and THEN attempt reimbursement. Does anyone have any sense of whether insurers are more or less likely to pay if you have already had a successful surgery (I hope it will be successful). Thanks for any insights! Leora
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Large central L5-S1 herniation in late July 07 with progressive cauda equina symptoms. Laminectomy/discectomy on Sept 7 2007. Very difficult recovery. Still on disability, working 2 hrs/day from home in a chaise lounge  Nerve issues in both legs an
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#2
01-01-2009, 11:38 PM
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Not sure which is better
Once you pay you will probably need to get a lawyer. I am not sure if you already tried to get authorization or have gone through the appeal process? I had the surgery because I could not wait but had already done all the appeals and had been denied. The Insurance really doesn't care. When I used Dr. Delamarter I was not sure the letter he wrote was personal but rather directed the Insurance to the FDA approval. I am one year out and have not seen anything but the lawyers fees.
Phylly
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Cervical fusion C4-C6 2002 Fall on tailbone April 2005 Discogram concordant at L4-S1 2007 for back pain not leg pain Prodisc ADR surgery L4-L5-S1 November 2007 Decompression surgery L4-S1 for left sided sciatica July 2008 Continued back and leg pain, looking at possible fusion Removal of Prodiscs and L4-S1 fusion February 2009
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