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New Member Introductions If you just joined, please introduce yourself here. Please add a signature describing your spinal history (use the "User CP) and ask us how we can help you get started. |
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#1
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New Member
Hello everyone,
My name is Izzy and I recently underwent two level ADR surgery at Stenum Hospital in Germany. I had an auto accident in 1998 and had been suffering with four-level degenerative disc disease for over thirteen years. In March 2011 I decided to go Germany and I'm happy to report, my surgery was a total success. Unfortunately, I am currently fighting Anthem Blue Cross for reimbursement of my medical expenses. I'm in the process of appealing their denial and I was wondering if anyone has been successful in getting ADR surgery approved that could assist me with some basic information. I would greatly appreciate the help. Izzy |
#2
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Hi Izzy, Just wanted to say hi and welcome you. So glad to hear that your adr surgery was a success. I am having a one level at L5/S1 early February. What levels did you have done?
Sorry can't help you with your insurance issues, but hopefully some will chime in with their thoughts. Wishing you all the best! Karen
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41 years old Back injury Spring 2010 Discectomy/Lami Summer 2011..unsuccessful ADR L5/S1 Maverick L5/S1 Feb 6th 2012 |
#3
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Izzy welcome. Glad everything went well! Have you checked out the Insurance thread on this site? Lots of info...
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Joey Sue - 50 years old 9/28/2011: Hybrid STALIF TT interbody fusion at L5-S1 and M6-L ADR L4-5 with Nick Boeree, UK - forever grateful to you Nick! Still doing great. Prior to the fix: Severe DDD L4-5 and L5-S1 with moderate facet degen at L5-S1, but only mild facet degeneration at L4-5. http://healthyback2011.blogspot.com/ |
#4
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Welcome to the forum! I echo the others in being glad to hear your surgery was successful.
As for insurance, definitely check the insurance forum to see if there's anything useful there. I can't really assist on that end as I was very fortunate to have insurance with a company that seems to support ADR over fusion, so the process went smoothly with them. Well... minus some goofiness when I was in PT but that was less an insurance issue and more a billing and practice merger issue. Hope you find the info you need or someone familiar with your particular insurance sees your thread! ~Sara
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************************* 31 yrs old Lumbar herniation L5/S1 - Did mild PT, some chiropractics and self regulated pain management since initial sports injury in Spring 1997. - XRay and Bone Scan Jan/Feb 2007 - PT March to May 2007 - MRI Jan 2008 - Disco positive at L5/S1 Feb 2008 - ADR surgery at L5/S1 on June 23rd 2008 - Prodisc - Recovery - so far so good! ************************* |
#5
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Thanks for the warm welcome!
Thanks to all of you for the warm welcome and support.
To answer some of your questions, my ADR surgery was to cervical levels C4-5 and C6-7. I also had a fusion to level C5-6 back in 2001 but it only alleviated some of my symptoms for a little over three years. Best regards, IZZY |
#6
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Izzy,
Congratulations on your successful ADR at Stenum, and welcome. Getting reimbursed AFTER surgery is much more difficult than getting your carrier to agree to cover the surgery before hand. I say that because I've seen the latter happen, but never the former. I worked for over a year for reimbursement before capitulating to a bad-faithed BCBS-TX. I've PM'd you my failed third appeal. It s a beautiful work of art, but in the end did me no good. Hopefully you'll be able to glean something useful from it. 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 |
#7
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i decided that it would cost me more to fight Aetna ahead of time and wait/argue, then to just pay and get on with my life... ie, be able to return to work. that is not everyone's situation, but it was mine and it has turned out exactly how i thought it would... returning to work 2/15!
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US non-spine MD - laid up no more!!! had recurrent annular tear L5/S1, failed everything M6L done 10/19/11 w/ Dr Clavel getting back to my old self more and more every week! laidupdoc@gmail.com if my PM box is full The content herein represents my professional thought and opinions in a general sense only; they do not constitute professional advice or services. if you need medical advice, please consult a licensed physician. |
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