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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
12-20-2007, 08:24 PM
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I am preparing my appeal and was wondering if people included a copy of the actual MRI (e.g., on CD) in their medical records for their appeal?
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2001 MVA; C5-C6 disk extruded ongoing physical therapy, exercise and massage ESI's, oral prednisone, trigger point injections foraminal and central stenosis C5/C6 and c6/C7 2007 EMG/nerve conduction shows pattern of chronic radiculopathy January, 2008: Prestige ST Artificial Disk Replacement, C5/6 
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#2
12-21-2007, 07:08 AM
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Sahuaro, I did not, but I think that is a superb idea. Real person, real images, real needs.
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CindyLou bicycle accident 6/19/01 2 compression fractures, T12, L1; vertibroplasty @ above levels, 9/15/01 4/06 hip labral tear repair 4/07 Lumbar ProDisc replacement by Dr. B., 3 levels; L3-6 7/2/08 ALIF of L6-S1 7/30/08 Removed bone cement. 8/7/08 Diagnosed with pulmonary embolism, double pneumonia, collapsed left lung, pleurisy, pleural effusion. 3/10/09 right SI Joint Fusion; seeing light at end of tunnel, for first time in 8 years!!
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#3
12-21-2007, 09:24 AM
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I think it's a good idea too. I hate to wonder, though, how many people even look at them. If they did, would it mean anything?
That's where the radiologist(s) reports come in real handy -- to break it down into factual terms. Include all the study reports too. If you went to the same institution, they will often (always?) compare degenerative changes since the last image study, which can be quite helpful.
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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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#4
12-21-2007, 06:35 PM
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Thanks, CindyLou and Harrison for your thoughts. I've actually decided not to include the MRI for very cynical reasons: I've already been burned by an "independent" medical examiner without formal training in reading MRI's who had no qualms testifying that "my nerves had plenty of room" despite significant foraminal stenosis and accompanying symptoms. Why give the insurance company more wiggle room?
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2001 MVA; C5-C6 disk extruded ongoing physical therapy, exercise and massage ESI's, oral prednisone, trigger point injections foraminal and central stenosis C5/C6 and c6/C7 2007 EMG/nerve conduction shows pattern of chronic radiculopathy January, 2008: Prestige ST Artificial Disk Replacement, C5/6
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#5
12-21-2007, 08:23 PM
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Sounds like you need a lawyer who is also a doctor. There are some around that have both specialties and can eat those independent reviewers for lunch.
Good Luck. Like it said in Legends of the Fall; "Screw the Bastards......Screw em'". Terry Newton
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1980 ruptured L4-L5 1988 ruptured SI-L5 1990 ruptured C5-C6 1994 ruptured C6-C7 1995 Hemi-Laminectomy C5-C6, C6-C7 Mayo Clinic Bicycle Accident 2004 MRI, EMG, Facet Injections, Epidural Blocks, Lumbar Discogram. Stenum Hospital Surgery November 4, 2006 Prestige Disc C5-C6, C6-C7 Maverick Disc S1-L5, L4-L5
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