ADRSupport Community  

Go Back   ADRSupport Community > General Discussion > Insurance Hell

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.


Reply
 
Thread Tools
  #11  
Old 07-12-2007, 05:50 PM
Abbe Abbe is offline
Member
 
Join Date: Feb 2007
Posts: 61
Default

Wow! What an ordeal Cindy! I think you did a fine job and came out a winner I have been lurking and reading your posts. I am still in the insurance battle and go for nerve conduction tests tomorrow. Wish I could afford to go to Germany let alone have the surgery! I just went ahead and applied to Atnea.
Who knows!! Maybe I'll get lucky

Abbe
__________________
Water ski accident 86'
Chiropractic& PT Pain meds
Discectomy Laminectomy
L5 S1 Partially sacralized
97' epidural injections
L3 L4 ruptured and torn
L4 L5 Almost no disk height left along with osteophytes
Left leg pain and tingling going down back of leg into heel & foot
3 appeals with BCBS no success Lost insurance.
Kaiser Permanente
L3-L4, L4-L5 Prodisc 9/18/09
C5-6 & C6-7 ruptured and looking at hybrid surgery fusion & Prestige ADR
Reply With Quote
  #12  
Old 07-13-2007, 08:58 AM
CindyLou's Avatar
CindyLou CindyLou is offline
Senior Member
 
Join Date: Mar 2007
Posts: 627
Default

Good luck with your nerve conduction tests today Abbe, and I hope you get lucky too! Thank-you for your kind words as well.

Chuck, I hope you don't find me "ungrateful" for pursuing and hoping for the whole compensation. I'm allowed to be disappointed, and $67,540 divided in half, and after taxes is more like $18,000 to $19,000, not $33,000. (we pay huge state taxes here in Minnesota) So, yeah, I'm more than a little disappointed, but I'll get over it. But I don't appreciate your words or tone, which implies to me that: #1, you consider me a whiner, and more importantly, #2, I am not at liberty to express myself honestly on this board.

Things are getting a little dicey with this whole thing because: my husband has had a more difficult time with it, and decided he wanted to write to the lady at HR, expressing his disappointment with the final decision. Well, she shot him an email back saying "how dare he be disappointed" blah, blah, blah, and putting the Pres. of the co. in this difficult position. And then where she really went WRONG, was she cc'ed a copy of it to Rick's boss (who knows nothing of this whole thing because, hello, HIPA)! and of course cc-ing it to the Pres., which she should. So, needless to say, my husband is livid for the HIPA violation, and I suspect he will request a meeting w/ the Pres. today. I had also remembered one night when I wasn't sleeping well, that she told me she had talked to her husband about it, asking him if he would have spent $70,000 on her if she had a bad back, and he said yes. Another HIPA violation, talking to her husband, who we also happen to have a relationship with as our insurance agent! What a mess. I sure hope my husband doesn't get fired today.
__________________
CindyLou
bicycle accident 6/19/01
2 compression fractures, T12, L1;
vertibroplasty @ above levels, 9/15/01
4/06 hip labral tear repair
4/07 Lumbar ProDisc replacement by Dr. B., 3 levels; L3-6
7/2/08 ALIF of L6-S1
7/30/08 Removed bone cement.
8/7/08 Diagnosed with pulmonary embolism, double pneumonia, collapsed left lung, pleurisy, pleural effusion.
3/10/09 right SI Joint Fusion; seeing light at end of tunnel, for first time in 8 years!!
Reply With Quote
  #13  
Old 07-13-2007, 09:18 AM
Justin Justin is offline
Banned
 
Join Date: Oct 2004
Posts: 954
Default

Hi Cindy,

I hope things work out for you. I truly think Chuck was being supportive and had the best intentions in his post.

Justin
Reply With Quote
  #14  
Old 07-13-2007, 10:35 AM
Harrison's Avatar
Harrison Harrison is offline
Administrator
 
Join Date: Oct 2004
Posts: 7,010
Default

Justin, well said. Cindy, thanks for sharing your story, and good luck during the coming days.
__________________
"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
Reply With Quote
  #15  
Old 07-17-2007, 08:19 AM
CindyLou's Avatar
CindyLou CindyLou is offline
Senior Member
 
Join Date: Mar 2007
Posts: 627
Default

Well, nothing happened at the office. Rick took Monday off and went in for a short time this a.m. before he flies to east coast. So, he initially just wrote his cover letter for the "half" we are promised, and I have to get the bills from Bogen copied again to submit directly to the Pres, instead of the healthcare provider. I think Rick will then write some kind of note addressing how he thought it to be inappropriate for my "medical appeal stuff" to be forwarded to his boss, and maybe toss in a question like: "isn't that a violation of HIPAA?"

And, Chuck, to you, I am sorry if I misinterpreted your intentions about the refund appeal. I am clearly pretty "touchy" and sensitive about the whole issue. And thank-you Justin for your take on it. I do need to get this all behind me, that's for sure.
__________________
CindyLou
bicycle accident 6/19/01
2 compression fractures, T12, L1;
vertibroplasty @ above levels, 9/15/01
4/06 hip labral tear repair
4/07 Lumbar ProDisc replacement by Dr. B., 3 levels; L3-6
7/2/08 ALIF of L6-S1
7/30/08 Removed bone cement.
8/7/08 Diagnosed with pulmonary embolism, double pneumonia, collapsed left lung, pleurisy, pleural effusion.
3/10/09 right SI Joint Fusion; seeing light at end of tunnel, for first time in 8 years!!
Reply With Quote
  #16  
Old 07-17-2007, 12:29 PM
chasswen chasswen is offline
Senior Member
 
Join Date: Apr 2006
Posts: 627
Default

no problem cindy
and remember no hose pulling for a bit longer.
you are still very early on.
i was single level and was told 12 weeks before any man labor.
and remember PT will be very helpful as those back and core muscles need to be built up again.
chuck
__________________
ddd 1990
2003 mri,xrays,shots,emg
2004 discogram ouch pos l4 l5
facet block neg
lost all appeals BCBS 5 months of that
3 surgeons later
surgery with dr. bertagnoli aug 2nd 2006 in Bogen Germany Successfully ProDisc-L L-4 L-5
Reply With Quote
Reply

Bookmarks

Thread Tools

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off


Similar Threads
Thread Thread Starter Forum Replies Last Post
NOTHING FINAL Hilary The Big File 0 09-01-2008 06:43 PM
Gotta NO on final appeal!!! Cat-mt The Big File 5 08-24-2005 12:22 AM
Final appeal - External review bmills The Big File 12 06-27-2005 01:25 AM


All times are GMT -4. The time now is 07:25 AM.


© Copyright 2006-2023 ADRSupport.org All rights reserved.