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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
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The good news:
Got a surgeon experienced in ADR (Dr. Bradford Mullin [Columbus, OH], participated in original FDA study, has done about 100 ADR surgeries) that agrees that a Charite replacement is the best option for me. The hard to categorize news: Not really sure what UHC is going to do. I am presuming that they will deny. Guess I will find out in the near future. If they approve me, then so be it (unlikely). If they deny me (repeatedly), then I will at least consider Germany. If Germany is around $30k, and here in the U.S. is significantly more, and I have to foot the bill, then that is an easy decision. The bad news: I need to get *another* discogram (just had one done in February). Why? Short answer - previous surgeon didn't produce any films. Long answer - Previous forum post At least my life is starting to move in the direction that I want it though. David
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47 years old Surgery: 14-NOV-2006; Straubing, Germany (Dr. B.) L4-S1: Prodisc |
#2
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David welcome to the ratrace we call the insurance appeals process. I just turned my first and only appeal with Tricare (military) insurance, so if you need any of the paper work that I have gathered from this site and on my own just let me know. Cathy
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Lumbar pain after 2 MVA's Numerous blocks and epidur's 2 discograms IDET July 2003 L4/L5 & L5/S1. |
#3
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Thanks. I will definitely keep that in mind. It is highly likely that I will be taking you up on that offer eventually.
David
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47 years old Surgery: 14-NOV-2006; Straubing, Germany (Dr. B.) L4-S1: Prodisc |
#4
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Good luck, I just got my final denial from my Benefits Committee today. Calling UHC to schedule fusion asap.
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John Greensboro, NC DDD L5-S1 Lost all ADR Appeals w/ UHC PLIF Fusion L5-S1 on 5/17/05. Pars Defect L3-L4 DDD L3-L4 L4-L5 3 LVL Fusion Scheduled 4/08 |
#5
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Sorry to hear that. I am pretty much presuming that the same *may* happen to me.
If I am fully denied, then I will probably just head to the AK in Germany. [do you mind if I ask in general why they denied you? Of course, feel free to say that you mind] David
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47 years old Surgery: 14-NOV-2006; Straubing, Germany (Dr. B.) L4-S1: Prodisc |
#6
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Sorry John, I am right behind you with UHC here in VA. I should be submitting my first paperwork next month after I get back from the AK and having the tests done. I would also be very interested to know what their grounds were. This was now the appeal to your company as the "self insured" plan right?
You don't happen to work for a major telecom company do you?
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Juli DDD L3-L4 on down since 1990 Surgery 9/26/05 with Dr. Bitan in NYC to complete partial congenital fusion of L5-S1 and ADR at L3-L4 and L4-5. Feeling great! |
#7
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"You don't happen to work for a major telecom company do you?"
Interesting question. Depends on how you define "major", but yes, I do work for a telecom company here in Ohio. David
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47 years old Surgery: 14-NOV-2006; Straubing, Germany (Dr. B.) L4-S1: Prodisc |
#8
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I was actually addressing that to John, because I know my company has a presence in Greensboro. But that is a coincidence as we all have UHC. Is your company's headquarters in Ashburn VA? I work at our headquarters building, but we have buildings in almost all of the states. I know we have a major center in Hilliard.
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Juli DDD L3-L4 on down since 1990 Surgery 9/26/05 with Dr. Bitan in NYC to complete partial congenital fusion of L5-S1 and ADR at L3-L4 and L4-5. Feeling great! |
#9
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Wow. That is extremely ironic.
I am guessing that you work for MCI? (I drive past the Hilliard office twice a day) I work for the telecom that attempted to buy MCI, but failed miserably David
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47 years old Surgery: 14-NOV-2006; Straubing, Germany (Dr. B.) L4-S1: Prodisc |
#10
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Bingo and gotcha!
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Juli DDD L3-L4 on down since 1990 Surgery 9/26/05 with Dr. Bitan in NYC to complete partial congenital fusion of L5-S1 and ADR at L3-L4 and L4-5. Feeling great! |
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