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#1
09-03-2013, 04:31 PM
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has anyone won an appeal for lumbar ADR when considered "investigational"?
Hello. I'm a newbie in this support group. I have been denied a level 1 ADR on my L5 - S1 by my insurance co. I have BCBS of Louisiana and they have a policy against ADR calling it "investigational". I have decided to appeal as I don't have the money to pay out-of-pocket. After 2 weeks of research, I'm overwhelmed and could use your help. Has anyone ever won an appeal for lumbar ADR when it's considered investigational that uses BCBSLA or used to be on OGB in LA........or even on a different insurance? If so, would you be willing to share your appeal with me? Thank you so much for any feedback & assistance anyone can provide.
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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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#2
09-03-2013, 07:43 PM
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Hi Andi, the answer is yes...
Pls see this forum, and start reading! Insurance Hell - ADRSupport Community
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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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#3
09-04-2013, 02:04 PM
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Thank you. I have been reading on this forum and find it very informational and helpful. I will keep reading.
What I need is to find a BCBS president for them paying lumbar ADR in Louisiana. State Employees Office of Group Benefits hired out BCBSLA in January 2013, so prior to January the insurance coverage would have been under Office Of Group Benefits. Has anyone won an appeal for ADR in Louisiana under BCBS or OGB?
__________________
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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