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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
08-16-2010, 08:08 PM
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The moment of truth
Today the impossible happened. I was approved for three-level adr-fusion-adr hybrid surgery. The fusion element was added to the mixed only very recently. Problem is that after thinking about it I do not want the fusion. I'd rather have 3 discs. Yes I know that sounds terribly spoiled. But is it delusional? Was I approved because of the fusion component? Will I risk it all by asking the surgeon to resubmit the request as an all adr operation? Is it a better strategy to request two-level adr then go back for the third later on?
I actually don't have much time to work it out becasue my insurance runs out in three weeks!!!! I desperately need to consult with someone that can give me some advice. I've been waiting for this for two years and I don't want to screw it up or to end up with the very surgery I've waited this long in order to avoid. Aaaahhhh! Frank
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http://www.frankgarcia.com/adr/ Last edited by Harrison; 08-17-2010 at 10:17 AM. Reason: Deleted email address; please use this forum or private messaging 
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#2
08-17-2010, 10:26 PM
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Frank,
I've thought about this on and off all day. I don't know what the best course of action would be, but can tell you this; that's a great problem to have! Please keep us posted, and good luck! Jeff
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C4/5 - ACDF in 2000 C5/6 - ACDF in 2002 C3/4 & C6/7 - M6 ADR, Nov 2009, Barcelona Conceded defeat to a manifestly disingenuous BCBS-TX in my quest for reimbursement, Jan 2011
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#3
08-18-2010, 08:45 PM
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Frank, what's your latest? Also, what levels are you talking again?
(Signature would be nice; see Tip for the Day....) 
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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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#4
09-12-2010, 12:49 AM
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Can we use your approval?
Hi Frank -
Hopefully you've come to a decision and had surgery and are feeling much better already. I have 3 Pro-DiscC's myself and happen to love them! I was blown away by your post! And I'm wondering... there are many of us out here whose insurance companies have denied us prior to, during and after surgery. Would you be adverse to letting us know the name of the company and the particulars such as date and your initials so that we can use it in our own appeals? This kind of information is as rare and precious as gold. Thanking you in advance and sending healing energies your way. Lauren
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Lauren 57yo Female Cervical stenosis with myelopathy Fusion 2006 C5/6 to address worst of 4 levels Fall 2009 return of symptoms Jan 29 2010: 3 level ADR in Bogen Germany by Dr. Bertagnoli -C3/4, C4/5, C6/7 with hardware removal 
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