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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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#21
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I you don't mind sharing, which insurance did you get the ADR approved through? I was just (repeatedly) denied by BCBS FEP and I am quite devastated. Since open season is coming around, I am hoping to switch to someone to try again! Any advice/input is highly appreciated!
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#22
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4/07:LBP + radiculopathy=severe L5-S1 herniation , 7/07:Micro-D, 08-09:Reherniation, 09-17: periodic residual symptoms (conservative modalities to maintain "stability" = prolotherapy, ESI/nerve blocks/facet injections, chiro, massage, phys ther), 7/17 pain in neck/right shoulder radiating into hand (no trauma involved), 7-10/17 Conservative treatment to date include physical therapy/dry-needling/facet-injections (C4/5 to C6/7). Researching surgical options should progression continue. |
#23
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Yeah your vertebrae might have been porous had you been inactive for quite a while. I had epoxy injected into my verts n thank God it held. Laterally I think means they come in from the side of your obliques? Good luck bro I wish you a painfree life. But your mess seem kind of light how much pain were you in that you went for surgery?
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12/22/04 blew L4-5 and L5-S1 out lifting wrong 4/1/05 back to work thanks to Oxy 11/11/13 hurt back lifting again 6/6/15 last of many MRI L4-5 medium paracentral bulge with juice leaking and mid to left bulge on L5-S1 No invasive procedures except steroid shots that did nothing n hurt wicked bad 9/24/2016 Adr surgery Bertagnoli>1 year doing great |
#24
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sorry for the late reply, I've been all over the place lately. My surgeon in Miami all but abandoned me after the initial denial, so I ended up retaining an attorney. I am still trying to get an urgent appeal processed but I am not really sure if that will do anything. I am from Florida, which state are you in? I contacted my senator here after BCBS kept stone-walling me and brushing me off. He asked me to sign a consent form because of HIPAA, no idea if this will make a different...for what it's worth, I am not going down without a fight! I just got evaluated by Dr. Bergatloni in Berlin, Germany. He is supposed to be one of the best but also pricey: for a one-level ADR, I got a price estimate for $32,000 Euros. I am still waiting for the evaluation from Dr. Dasai (Cologne, Germany). He also has a good reputation. I heard that the Texas Back Institute may offer cash-prices as well... I am so confused in terms of what device is best: I was initially going for the activL (that's the one the surgeon in Miami uses), TBI I believe does the ProdiscL, and Dr. Dasai uses the LP-ESP... What is your status/plan?
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42 y.o. female, athletic build, otherwise healthy L5-SI: Severe DDD with subtotal disc collapse, mild to moderate bil. foraminal stenosis. 2007: car accident, mild herniation, intermittent pain. 2012-17: pain chronic, progressive, resistant to conventional treatment. 06/2017: Discogram, MRI 10/04/2017: ADR surgery denied by BCBS (FEP), Pain is severe and disabling 04/04/2018: ADR surgery using LP-ESP disc with Dr. Desai ![]() |
#25
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Hello! Just wondering how you are doing after your ADR with Dr. Desai?
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