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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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  #11  
Old 11-08-2010, 02:33 AM
staci70 staci70 is offline
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Join Date: Nov 2009
Posts: 11
Default

Quote:
Originally Posted by Harrison View Post
Indeed, good news from Laurie Todd and her ADR client! Great work!

That being said, I deleted the actual (edited for template) appeal, written by Laurie and her client, from Zorro's message. I don't care to help the people working AGAINST patients by giving them helpful insights into our battles against them! If you need it, simply email me - or Zorro.

I just finished reading Laurie's Books and I'm preparing my appeal. Can you please send me the template when you have a chance?

Thanks,
__________________
"Staci70"
Airline injury 7/13/2009
C6-C7 Herniation w/ annular tear
C6-C7 ADR Prodisc-C on 11/07/2009
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  #12  
Old 07-10-2011, 08:47 PM
brianw48 brianw48 is offline
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Join Date: Jul 2011
Posts: 3
Default Approval letters

Does anyone have copies of Approval letters from Anthm/BCBS of California, for Cervical ADR?

I would very much like to have some names and examples of approvals for my appeal.

If you have an Appeal letter that worked with Anthm/BCBS of Californis, I would be interested in that as well.

Feel free to email to: brianw6212@gmail.com
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  #13  
Old 07-10-2011, 09:08 PM
brianw48 brianw48 is offline
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Join Date: Jul 2011
Posts: 3
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My name is Brian, and I have Anthm/Blue Cross of California Insurance.
They have denied my request for Artificial Disc replacement at C5-C6, even though my Dr. has stated that I am a perfect candidate for it. BCBS of CA calls it Investigational/Experimental. Has your insurance company (BCBS of CA specifically) paid for it after a denial? If so, I need reference information to prove precedent that they have paid for other people.

I will use your information in an appeal letter only,

I need your:
1. First and last names
2. Name of insurance company
3. Date of ADR
4. Doctor's name

Please send to brianw6212@gmail.com
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  #14  
Old 08-29-2011, 09:12 PM
semathes semathes is offline
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Join Date: Aug 2011
Posts: 6
Default Anthem BCBS appeal

I would like to join forces with anyone who has experience with Anthem BCBS or any other BCBS for that matter.

I'm in need of any successful coverages, appeals, court cases, etc. for lumbar ADR.
__________________
2007 lower back pain becomes continuous, original cause unknown
2010 physical therapy, xray, mri, pain meds, muscle relaxers
2011 diagnosed with bone on bone at L5-S1, bone loss occurring, 3x epidural steroids injections, continuous pain meds, ct scan, denied ADR by Anthem BCBS
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  #15  
Old 01-24-2014, 04:24 PM
VegasGuy13 VegasGuy13 is offline
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Join Date: May 2013
Posts: 13
Default

Quote:
Originally Posted by ZorroSF View Post
just received an email from Laurie todd about a successful ADR reversal.
Hi

In your message re: Laurie Todd you mention a copy of the successful appeal and a book. I don't see either here. I must appeal a C-5/6 denial and need all the help I can get. Please let me know where I can go to get this information. Thanks very much.

Larry
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  #16  
Old 01-26-2014, 01:47 PM
Jen93312 Jen93312 is offline
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Join Date: Aug 2011
Posts: 87
Default

I don't know how to include a link but you can do a search for the insurance warrior to find what you are looking for.
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Jen
C3 Bulge
C4 Bulge
C5 ruptured
C6 Bulge
7/2011 epidural that caused a "fragment to present itself"
10/2011 C5-C6 Foraminotomy & removal of fragment
Positive for left-sided Hoffman's reflex
Effacement of anterior spinal artery
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  #17  
Old 01-30-2014, 07:42 PM
VegasGuy13 VegasGuy13 is offline
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Join Date: May 2013
Posts: 13
Red face

My name is Larry Lipzen, and I have Blue Cross/Blue Shield of Insurance. BCBS has denied my request for an artificial cervical disc replacement. Has your insurance company paid for it? If so, I need
your:
1. First and last names
2. Name of insurance company
3. Date of treatment
4. Doctor's name
5. Date that the insurance company made the decision.

In my case, I paid up front for the surgery, but now want to be reimbursed. I am using Laurie Dodson's book as a guide and getting this information is vital.

Thanks so much

larrylipzen@comcast.net
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  #18  
Old 01-30-2014, 07:46 PM
VegasGuy13 VegasGuy13 is offline
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Join Date: May 2013
Posts: 13
Default Appeal template

If anyone can provide me with a recent successful template for an appeal for a artificial cervical disc replacement claim it would be very much appreciated. I am just beginning my appeal development now.

Thanks in advance,

larrylipzen@comcast.net
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adr insurance appeal, artificial disc replacement appeal, insurance appeal, spinal arthroplasty coverage

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