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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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Old 03-22-2016, 11:08 PM
orchid orchid is offline
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Join Date: Mar 2016
Posts: 1
Default Help! Need Lumbar Hybrid Surgery Insurance Precedents

I have UnitedHealthcare Insurance (UHC). UHC has denied my request for Lumbar Hybrid Surgery, which consists of a total disc replacement at one level and a fusion at the adjacent level.

Has your insurance company paid for it? If so, can you please provide the following information to help me establish precedent where insurance companies have paid for this treatment:

1. First and last names
2. Name of insurance company
3. Date of treatment
4. Doctor's name

Please send this information to me at sembry504 at gmail.com. Any help is greatly appreciated!

Last edited by Harrison; 04-23-2016 at 09:31 PM. Reason: changed email for sembry to reduce spambot activity
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Old 03-23-2016, 06:46 PM
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Cynlite Cynlite is offline
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Join Date: Mar 2015
Posts: 666
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I'm sorry you are going through this struggle. It's particularly hard when we don't feel well, I know that too well but, hang in there. Here's an article that might help you and another link I found in my notes when I was researching this last year.

https://ryortho.com/2013/08/landmark...o-pay-for-adr/

http://guides.wsj.com/health/health-...urance-denial/

This site has an enormous amount of information in it. There is a search bar at the top that you can use to try and find what you want. Good luck to you. Others have won this battle but, it's takes a lot of perseverance.
__________________
2006: epidural shots did nothing; 2 surgeons recommended 2 level fusion, I declined.
2007 - 2010 4 foraminotomy and cord decompression cervical surgeries and 2 endoscopic discectomy T7-T8 surgeries; total 6 with Dr. Jho (Pittsburgh,PA) My C6/C7 autofused around 2009.
2013 - 2015: epidurals 3 times (again did nothing) and 4 Radiofrequency ablation (or RFA) procedures.
2016 more RFAs, hit the 10 year mark of this insanity and pain, 3 level M6-C ADR with Dr. Clavel May 19, 2016
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