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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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looking for Lumbar ADR precedent in Louisiana
Hello. I am collecting data for my appeal to BCBS of Louisiana. I really, REALLY need a precedent as they have a policy against Artificial Disk Replacement.
In January of 2013 State Employees Office Of Group Benefits contracted BCBS to take over the administration of state employees health insurance. So, before 2013 the insurance company would have been State Employees Office Of Group Benefits or OGB. Does anyone know of someone that won an appeal in Louisiana for lumbar ADR to either BCBS or OGB? If so, please, PLEASE would you share what you are able so I can use this in my appeal? I really need this surgery as I'm tired of pain and living a compromised existence.
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years of bending from pottery profession lumbar pain since Aug. 2012 MRI findings: DDD at L2 & L3 w/mild retrolisthesis; DDD at L5 & S1 w/loss of disk height & w/desiccation surgeon recommends ADR at L5 & S1 |
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