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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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Old 12-06-2009, 02:59 AM
badbatzmaru badbatzmaru is offline
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Join Date: Oct 2009
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Default Reimbursement after surgery at Stenum?

I've searched around but didn't find any stories from people who've been reimbursed after a trip to Stenum. Is this true? I'm currently in appeal for my Prodisc-C here in the states, but I may end up deciding to go to EU for the M6. The Stenum rep told me that they've had success getting BCBS to reimburse for Prestige LP discs but not for the M6. But the rationale seemed flawed - Prestige LP was claimed to be reimbursable b/c of FDA approval, but the LP isn't approved - only the original Prestige is approved....

Anyway, I'm going to assume that if I go to Germany I'm paying out of pocket, but I would like to know if there is any chance at all of winning a reimbursement appeal for a non-FDA-approved device. I'd be happy to pay for the device if I could get the surgeon, hospital, anesthesiologist etc paid for by insurance. Hey, a guy can dream can't he?

Thanks,
B
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