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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 05-08-2009, 04:28 PM
jchebert1979 jchebert1979 is offline
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Posts: 66
Default BCBS of Louisiana

I live in Louisiana however, I have BCBS of TX. The surgeon who is going to perform my Prodisc-C said that one of his doctor colleagues needs an ADR and BCBS La will not give in. He said that he spoke to the guy at the top who has the last say so (the medical director?) and his words were "as long as I am in charge we will never approve artificial discs".

Just a heads up for anyone who has that carrier.
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Chiari 1 malformation - successful surgery 1-22-09
C5-6 herniation (extrusion) with moderate central canal stenosis and bilateral foraminal stenosis.
Prodisc-C @ C5-6 5-28-09

Herniations/Buldges @ C4-5, C6-7, C7-T1, T1-2, T3-4, T6-7, T11-12
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  #2  
Old 05-08-2009, 09:08 PM
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Harrison Harrison is offline
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Thumbs down Fusion is great for many indications...

...and for people that may have no other choices. That said, fusion technology has evolved significantly over the past 100 years (yes, I said one-hundred years), while many other treatment methods have been introduced.

What's the medical director's issue with preserving motion? Does he support any new treatments to help spine patients other than fusion?

BTW: Laurie Todd (Insurance Warrior) gives some good advice about people like this -- it's in her book and in the posts on this site...search with either term. This $20 investment has helped some patients on this site win BACK the cost of their ADR procedure! Not a bad ROI.

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  #3  
Old 05-15-2009, 03:59 PM
jchebert1979 jchebert1979 is offline
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Default BCBS TX approval of Prodisc-C

BCBS TX got all of my paperwork on 5/11/09 and I just called and they have approved it as of 5/15/09. I hope and pray that this disc is causing my problems.
__________________
Chiari 1 malformation - successful surgery 1-22-09
C5-6 herniation (extrusion) with moderate central canal stenosis and bilateral foraminal stenosis.
Prodisc-C @ C5-6 5-28-09

Herniations/Buldges @ C4-5, C6-7, C7-T1, T1-2, T3-4, T6-7, T11-12
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