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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  
Old 04-28-2008, 09:46 AM
SherryD SherryD is offline
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Its been 8mo now of constant pain and I am now on reduced hours at work. I live in Missouri, but my BC plan is from my home office PA. I have been through every level of pain management with no success, so surgery is the only option. I have a badly buldging disk in the C5/C6 region with bone spurs, have been diagnosed with DDD and have two strikes against the C6/C7 disk. My doctor has reccomended ADR using the ProDisc-C for the C5/C6 disk and of course have been denied by BC. I am a young 37 year old who lives an active lifesyle and fusion is not an option. Can anyone please send me anything I can use to fight BC? Acceptanc letters espically from any BC affilate would greatly help. Thanks in advanced!
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Old 05-04-2008, 01:07 PM
mmarsh mmarsh is offline
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Sherry

Call the ProDisc hotline, you can find the number on the Synthes website. They can tell you who is authorizing ADR. There are some BCBS companies that are okaying them. Good luck.
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fusion L4-5, Dynesys rods L3-4, fusion c5-6 and C6-7, current problem C-7/T-1
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Old 05-04-2008, 03:42 PM
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Terry Terry is offline
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SherryD:

Blue Cross of Michigan covered my entire 4-Level ADR surgery and all subsequent back issues. This was done in November 4, 2006 and the approval took place in January of 07. Best of luck.

Terry Newton
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1980 ruptured L4-L5
1988 ruptured SI-L5
1990 ruptured C5-C6
1994 ruptured C6-C7
1995 Hemi-Laminectomy C5-C6, C6-C7 Mayo Clinic
Bicycle Accident 2004
MRI, EMG, Facet Injections, Epidural Blocks, Lumbar Discogram.
Stenum Hospital Surgery November 4, 2006
Prestige Disc C5-C6, C6-C7
Maverick Disc S1-L5, L4-L5
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