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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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Lindstrom Healthcare Advocacy
Hello, I am new to this group. I have been denied twice for ADR surgery at C 5 by my insurance company ......Blue Cross of Idaho. I am considering using the assistance of Lindstrom Healthcare Advocacy to try for a reversal. Any input would be greatly appreciated.
Thanks, Mike
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Body Builder/Trainer C5 Radiculopathy- with only major weakness in right bicep and deltoid, no pain. Unacceptable Insurance denial of ADR Grade 2+ spondylolesthesis at L5/S1 (I can deal with the pain as long as I am active) May 8 2015----3 Level Cervical ADR @ C4-C5-C6 With Dr. Clavel |
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Hi iron,
Lindstrom is a legal firm, yes?? Do they charge a fee? I'm assuming they do. What was the reason for denial? Did you already appeal once? You stated they denied twice. My surgeon and his office use MCRA. They are handling my case. They don't charge the surgeon or patient as I think they have incentive from the prosthetic company. Kelly
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2004 MRI -cervical bone spur causing pain 2011 MRI -5 bulging discs at C3-7: Recommended C5-6 and C6-7 for a two level fusion, I said no thanks. 2014 MRI -progressive compression C5-7. MRI 6/5/14- Ruptured L4-5, bulge at L2-3 and L5-S1 Dr recommends discectomy of L4-5 but won't do surgery until cervical is stable 8/2014- 8 months/3 rounds of appeals, Aetna denies 2 level cervical ADR 2 level ADR w/ mobi-c C5-7 Jan 7, 2015 |
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Yes Lindstrom is a advocacy group of lawyers who will represent me in my appeal. They do charge a fee.
I have been denied twice. I had my surgeon send an appeal after the first denial, only to be denied a second Time. Both times the denial reason was experimental surgery. Wow, how many of these things have been performed around the world to this date? I would bet hundreds of thousands . Kelly, do you happen to know the prosthetic brand you are trying to have? Mine is Pro-disk C. Thanks for the reply and good luck in your venture for better health.
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Body Builder/Trainer C5 Radiculopathy- with only major weakness in right bicep and deltoid, no pain. Unacceptable Insurance denial of ADR Grade 2+ spondylolesthesis at L5/S1 (I can deal with the pain as long as I am active) May 8 2015----3 Level Cervical ADR @ C4-C5-C6 With Dr. Clavel |
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I'm on my last round appeal with Aetna for the mobi-c. I need a two level. Pro disc is made by Synthes, I would call them. I called LDR, the company that makes mobi-c. They put my surgeon in touch with MCRA to help with my case. They are getting a lot of positive outcomes for patients. I believe there are other companies out there as well that are helpful. Sometimes they want to go through your surgeon though, so if your Dr. Is willing, he could contact them as well.
Hope this helps!
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2004 MRI -cervical bone spur causing pain 2011 MRI -5 bulging discs at C3-7: Recommended C5-6 and C6-7 for a two level fusion, I said no thanks. 2014 MRI -progressive compression C5-7. MRI 6/5/14- Ruptured L4-5, bulge at L2-3 and L5-S1 Dr recommends discectomy of L4-5 but won't do surgery until cervical is stable 8/2014- 8 months/3 rounds of appeals, Aetna denies 2 level cervical ADR 2 level ADR w/ mobi-c C5-7 Jan 7, 2015 |
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Thanks Kelly. Good luck. I will keep my fingers crossed for you.
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Body Builder/Trainer C5 Radiculopathy- with only major weakness in right bicep and deltoid, no pain. Unacceptable Insurance denial of ADR Grade 2+ spondylolesthesis at L5/S1 (I can deal with the pain as long as I am active) May 8 2015----3 Level Cervical ADR @ C4-C5-C6 With Dr. Clavel |
#6
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Moving this to the Insurance Hell Forum
For better access and long-term searching.
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"Harrison" - info (at) adrsupport.org Fell on my ***winter 2003, Canceled fusion April 6 2004 Reborn June 25th, 2004, L5-S1 ADR Charite in Boston Founder & moderator of ADRSupport - 2004 Founder Arthroplasty Patient Foundation a 501(c)(3) - 2006 Creator & producer, Why Am I Still Sick? - 2012 Donate www.arthropatient.org/about/donate |
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adr appeal, blue cross denial, fusion vs adr, lindstrom |
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