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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  
Old 05-12-2008, 01:22 PM
SherryD SherryD is offline
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I am fighting with BCBS in PA to get just a single level C5/C6 ProDisk-C replacement. Although the C6/C7 disk is also pretty bad, my doctor is not as concerned at this time. I need document approval letters from BC anywhere to submit to my insurace carrier to help with my appeal. Can anyone help? Thanks
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Old 05-12-2008, 04:31 PM
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Harrison Harrison is offline
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Sherry, I'd be happy to help. Let's catch up later this week by phone. : )

PS: Please insert a signature, per the welcome email. Also, please read the terms of service carefully.
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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
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Old 06-09-2008, 03:15 PM
Cali310 Cali310 is offline
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Hi Harrison,

I would also appreciate copies of approval letters for my hearing with Blue Cross of CA. I have already had the ADR surgery with ProDiscs at L4-S1. BC has denied me twice so I am asking for a hearing to keep fighting. Please let me know the best way to send the copies.

Thank you,
Cali
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  #4  
Old 06-19-2008, 03:29 PM
sanlee sanlee is offline
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My name is Sandy Wingfield. Two specialists have said that I need disk replacement. BCBS of NE has denied coverage. I too need copies of approval letters for my appeal.

Sandy Wingfield
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Fighting with BCBS for ADR and State Farm


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  #5  
Old 06-30-2008, 03:19 PM
ans ans is offline
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I need copies of approval letters for BC of CA and BC/BS of NY please - anyone.
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Severe, extensive DDD, considered inoperable by Dr. Regan, Lauressen, & some guy at UCLA. Severe foraminal stenosis (guess they can't operate!) and some spinal cord compression that Lauryssen would fix if gets outta hand.
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  #6  
Old 06-30-2008, 07:52 PM
phylly phylly is offline
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Richard,
I would also love copies of any appeal letters, I am embarking on my litagstion also. Any help would be appreciated.
Phylly
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Cervical fusion C4-C6 2002
Fall on tailbone April 2005
Discogram concordant at L4-S1 2007 for back pain not leg pain
Prodisc ADR surgery L4-L5-S1 November 2007
Decompression surgery L4-S1 for left sided sciatica July 2008
Continued back and leg pain, looking at possible fusion
Removal of Prodiscs and L4-S1 fusion February 2009
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Old 07-01-2008, 05:54 PM
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Harrison Harrison is offline
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Hi all,

A while back, I suggested that everybody consolidate their resources - and offered to receive successful appeals. Is that still a good idea? I think it is, so I'll ask people to send them to me.

However, why should people do this? How can we incent them to help others like you?

This takes me a lot of time. So let me know if there are ways to streamline the process.
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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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  #8  
Old 07-01-2008, 08:20 PM
phylly phylly is offline
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Richard,
In terms of streamlining a process, (because I know handling that much info is a lot of work!) and I do not know if this is "kosher", but what if people take out the personal info on their appeals and you post them on one of the sites as attachments? Are you able to have that capacity on this site? (way too long a sentence and I hope it made sense)
Phylly
__________________
Cervical fusion C4-C6 2002
Fall on tailbone April 2005
Discogram concordant at L4-S1 2007 for back pain not leg pain
Prodisc ADR surgery L4-L5-S1 November 2007
Decompression surgery L4-S1 for left sided sciatica July 2008
Continued back and leg pain, looking at possible fusion
Removal of Prodiscs and L4-S1 fusion February 2009
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