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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
07-02-2007, 07:46 PM
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Hello all,
Today I stumbled upon this new study done by "TEC" Technology Evaluation Center assesment program. The evaluation states 5 criteria at the end of the study that they feel must support ADR effectiveness in order to approve the device and cover it under their plans. http://www.bcbs.com/betterknowledge/...s/22/22_02.pdf
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Water ski accident 86' Chiropractic& PT Pain meds Discectomy Laminectomy L5 S1 Partially sacralized 97' epidural injections L3 L4 ruptured and torn L4 L5 Almost no disk height left along with osteophytes Left leg pain and tingling going down back of leg into heel & foot 3 appeals with BCBS no success Lost insurance. Kaiser Permanente L3-L4, L4-L5 Prodisc 9/18/09 C5-6 & C6-7 ruptured and looking at hybrid surgery fusion & Prestige ADR 
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#2
07-03-2007, 10:25 AM
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It's interesting to see "better knowlege" as part of the URL, as their site includes data and research that is a tad crusty..er, rusty. E.g. 1997?! Wuddupwidat?
Citing the age of some of this data can only help you with your appeals! Thx for sharing. Just a reminder, many BCBS companies HAVE paid for ADR, so it's up to you to learn how to play their cruel game of appeals. 
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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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#3
07-03-2007, 07:30 PM
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Good point Harrison.
Thanks for digging this up.
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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.
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