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  #1  
Old 03-21-2005, 02:34 PM
NCFUSED NCFUSED is offline
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In my quest for information for my Insurance Appeal I have found the following:

http://www.kff.org/consumerguide/

http://www.healthinsuranceinfo.net/

http://www.naic.org/ (has links to each states ins. boards)...

Hope this is helpful!
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John
Greensboro, NC
DDD L5-S1
Lost all ADR Appeals w/ UHC PLIF Fusion L5-S1 on 5/17/05.
Pars Defect L3-L4
DDD L3-L4 L4-L5
3 LVL Fusion Scheduled 4/08
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  #2  
Old 03-21-2005, 03:21 PM
biffnoble biffnoble is offline
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Thanks John!
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Cervical ADR of interest.
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  #3  
Old 03-21-2005, 03:29 PM
domedude domedude is offline
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My read on this is that you cannot use this appeal avenue if the denial is based on the procedure being classified as experimental. I think that seems to be the wording on most denials(it was on mine).

Steve
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  #4  
Old 03-21-2005, 03:57 PM
NCFUSED NCFUSED is offline
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UHC has been using "not a proven service" terminology.

From what I have read "experimental" is used because most of the companies have not changed the wording of their medical policies since before the FDA approved the Charite in Oct. I know UHC was using Experimental, then changed it to unproven......

I would appeal anyway, all they can do is say no....right???
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John
Greensboro, NC
DDD L5-S1
Lost all ADR Appeals w/ UHC PLIF Fusion L5-S1 on 5/17/05.
Pars Defect L3-L4
DDD L3-L4 L4-L5
3 LVL Fusion Scheduled 4/08
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