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| The Big File All issues not easily categorized in the above forums are here. Comments on general health, diet, "getting comfortable," and more are here. |
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#1
06-02-2006, 08:35 AM
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I have my medical review phone call this next Wednesday. I have 10 minutes to "state my case" and then they have eternity to grille me I guess. (okay - nuff of that - another thread!)
Somewhere in this site I found a link to a website that actually showed the number of discs approved under which insurance company. Does this sound familiar to anyone??? Please - I'm not sure what to even search for and was hoping someone could just post the link?!? Thanks
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Juvenile Discogenic Disease 2 level ACDF C5/6, C6/7 Redo on C6/7 PLIF L5/S1 - hdwr removed when C6/7 revision PLIF L4/5 & Dynesys L3/4 10/10/06. Looking forward to living again. 
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#2
06-02-2006, 09:21 AM
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I am not familiar with that post, but I was able to drag up the following:
Aetna approval for 1 level Charite BCBS NJ Charite approval - 1 level Hope this helps a bit. David
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47 years old Surgery: 14-NOV-2006; Straubing, Germany (Dr. B.) L4-S1: Prodisc
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#3
06-02-2006, 09:32 AM
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Is this what you're reffering to?
http://www.charitedisc.com/charitedev/domestic/patients...r2/docs/coverage.pdf It's Charite's list of which companies have coverage policies and then has a table of number of decisions.
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Injured 9/01 Annular tears L4/5 & L5/S1 denied adr by insurance for 2 level charite as well as hybrid fusion at L5/S1 with Charite at L4/5. New ins paid for 2 level lumbar prodisc surgery on 4/7/08 (at age 39) with Dr. Westerlund, at Core Orthop
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#4
06-02-2006, 09:41 AM
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And there's other resources on that site that are helpful as well:
http://www.charitedisc.com/charitede...ement.asp#keys Good luck with the process -- been there done that and it's really frustrating!
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"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
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#5
06-02-2006, 12:36 PM
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I went ahead and downloaded the Charite pdf document to my website, for future reference...
ADR documents - my website Thanks. David
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47 years old Surgery: 14-NOV-2006; Straubing, Germany (Dr. B.) L4-S1: Prodisc
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#6
06-03-2006, 07:36 AM
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Thanks David! For future reference, members can attach helpful documents.
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"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
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#7
06-03-2006, 09:42 AM
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LBP - THAT'S IT!!!
Thank you so much. AND, since I last viewed it, which wasn't that long ago, United Health Care which bought out or merged with PacifiCare, right? hadn't had any approved. Now, they've had 3. That is exciting!!! Thanks everyone for responding.
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Juvenile Discogenic Disease 2 level ACDF C5/6, C6/7 Redo on C6/7 PLIF L5/S1 - hdwr removed when C6/7 revision PLIF L4/5 & Dynesys L3/4 10/10/06. Looking forward to living again.
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#8
06-03-2006, 10:28 PM
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Go Big Red,
don't know if this will help your case but in addition to Pacificare being a UHC company, so is Golden Rule and according to the list, Golden Rule also has 1 individual coverage case.
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Injured 9/01 Annular tears L4/5 & L5/S1 denied adr by insurance for 2 level charite as well as hybrid fusion at L5/S1 with Charite at L4/5. New ins paid for 2 level lumbar prodisc surgery on 4/7/08 (at age 39) with Dr. Westerlund, at Core Orthop
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#9
06-04-2006, 01:55 AM
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Thanks for sharing your website.
ans
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Severe, extensive DDD, considered inoperable by Dr. Regan, Lauressen, & some guy at UCLA. Severe foraminal stenosis (guess they can't operate!) and some spinal cord compression that Lauryssen would fix if gets outta hand.
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#10
06-06-2006, 04:32 AM
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Interesting how on the mark this is. I'm in NJ but am covered under Pennsylvania's Liberty Mutual Workers Comp. It took a letter/phone call from my company's medical director for them to approve a NY doctor (Jeff Goldstein) to do my disc replacement. Plus I was a big pain in the arse. This is great info. Keep that good stuff comin!
GAWD what the heck am I doing at work today!?! My pain level is 9/10. I am going to be so drugged up soon I will be useless. It's better than sitting home I guess...
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12/16/03 Work Accident Herniation and DDD at L4-L5 4/1/05 Discectomy Epidurals and facet injections 5/15/06 Discogram confirmed L4-L5 DDD also an asymptomatic L5-S1 tear 10/24/06 L4-L5 Prodisc surgery with Dr. Goldstein CAT scans & X-Rays show ossification Trigger Point Injections, Medial Branch Blocks, Acupuncture, Weekly Deep Tissue Massage 10/27/08 Discogram (positive L5-S1 tear)  11/25/08 L5-S1 fusion with Dr. Goldstein FAILED BACK SYNDROME Liberty Mutual WC
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