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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 10-12-2007, 11:19 AM
Slackwater Slackwater is offline
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CIGNA denied two-level, L4-S1, ADR w/Pro-Disc at UCSF, San Francisco California.

Is there a template for a successful appeal?

Dr. Derby gave me the ESI procedure(epidural steroid injection) or Selective Nerve Root Block, 10/10/07. It will be used as a diagnostic also. Somehow it will be related to the facet joints. Dr. Derby is a thumbs up gentleman with a great staff, smiles. I think he is world class, and he is a straight shooter.
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2004 MVA, 2-level lumbar surgical candidate
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Old 10-15-2007, 04:58 PM
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Harrison Harrison is offline
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Call me this week, I'll provide a template, resources and consultants that may be able to help you.

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Old 10-22-2007, 05:35 PM
Slackwater Slackwater is offline
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Quote:
Originally posted by Harrison:
Call me this week, I'll provide a template, resources and consultants that may be able to help you.

Thank you for the offer regarding insurance appeal; it is apperciated. Scratching my head on what to do next. I will call/email after Nov 4.

ADR is probably available if I pay for it myself, in this country or Germany. That poses the big question, "am I convinced yet?"

I'm convinced I want to change my physical condition to avoid living with disability for 30-X0 more years. There are trade-offs in other dimensions of health with limited physical activity, (ref: JAMA walk 1/4 mile in 5 minutes or ... ).

The last procedure was a Selective Nerve Root Block (SNRB), aka Epidural Steroid Injection (ESI). I think this may also be a diagnostic on the facets, one of my un-answered question from visiting UCSF. I want the diagnostic on the facet joints and we'll see if this patient still qualifies for ADR/TDR or ...

NASS annual mtg edition of Spine is online with some open access to articles.
NASS annual mtg abstracts online also.
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