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  #1  
Old 01-22-2011, 01:43 PM
breckpetekaren breckpetekaren is offline
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Join Date: Dec 2010
Posts: 2
Default Self Paid because insurance refused to Pay

My summary:
2005 disc fusion of C5-6
2007 partial discectomy of C6-7
2008 replaced disc at C6-7 with artificial Prodisc-C
2011 replaced disc at C4-5 with artificial Prodisc-C
Disc replacements performed by Dr. Paul McAfee in Towson, MD
I have Degenerative disc disease.
Cigna insurance paid for the first 3 surgeries and then on the 4th said the Prodisc-C is expeirimental.
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  #2  
Old 01-22-2011, 09:35 PM
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Harrison Harrison is offline
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Join Date: Oct 2004
Posts: 7,014
Exclamation

Pete,

It's amazing isn't it -- the hurdles one must face -- after winning the race of pain management, research, finding the right option...then bing punished financially. It is nuts.

Please tell us how you are doing! How is your pain? QOL? Is your "experiment" a success?!
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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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  #3  
Old 02-15-2011, 11:58 PM
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DAnn DAnn is offline
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Join Date: Dec 2010
Posts: 73
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Pete,
I don't understand why insurance companies say that (I'm going through the same issues) when it has been through the rigorous process of FDA approval.

Perhaps it is the two level ADR, but you had them done at different times.
It must be frustrating, but I hope you are feeling better and get well enough to fight insurance later.
Take care,
DAnn
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DAnn
DDD/Cervical Stenosis
September 2010 MRI showed:
C6-7 disc moderately to markedly narrowed, mild retrolisthesis of c6 on c7 producing effacement of the thecal sac but no cord impingement, mild narrowing of left neural foramen;
c5-6 disc moderately narrowed, anterior and posterior disc bulge with mild anterior cord impingement;
c4-5 disc intact and normal height, potential posterior annular fissure.
Cervical hybrid surgery in Texas April 12, 2011, fusion at C6/7, Prodisc C at C5/6
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  #4  
Old 02-16-2011, 09:37 AM
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Jstuckey Jstuckey is offline
Senior Member
 
Join Date: Nov 2010
Posts: 305
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APPEAL APPEAL APPEAL. Maybe it just got in the hands of an old chronie that doesn't believe in these new gadgets. I'm appealing for the 4th time. A different third party reviewer sees it each time, and I'm hoping someone with half a brain gets their hands on my situation. You would seem to have a very strong case - 3 times paid? APPEAL!
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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/
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