ADRSupport Community  

Go Back   ADRSupport Community > General Discussion > The Big File

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.


Reply
 
Thread Tools
  #1  
Old 06-02-2006, 09:35 AM
go*big*red go*big*red is offline
Senior Member
 
Join Date: Jun 2005
Posts: 123
Default

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
__________________
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.
Reply With Quote
  #2  
Old 06-02-2006, 10:21 AM
David David is offline
Senior Member
 
Join Date: Mar 2005
Posts: 455
Default

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
__________________
47 years old
Surgery: 14-NOV-2006; Straubing, Germany (Dr. B.)
L4-S1: Prodisc
Reply With Quote
  #3  
Old 06-02-2006, 10:32 AM
LBP LBP is offline
Senior Member
 
Join Date: Aug 2005
Posts: 446
Default

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.
__________________
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
Reply With Quote
  #4  
Old 06-02-2006, 10:41 AM
Harrison's Avatar
Harrison Harrison is offline
Administrator
 
Join Date: Oct 2004
Posts: 6,917
Default

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!
__________________
"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
  #5  
Old 06-02-2006, 01:36 PM
David David is offline
Senior Member
 
Join Date: Mar 2005
Posts: 455
Default

I went ahead and downloaded the Charite pdf document to my website, for future reference...

ADR documents - my website

Thanks.

David
__________________
47 years old
Surgery: 14-NOV-2006; Straubing, Germany (Dr. B.)
L4-S1: Prodisc
Reply With Quote
  #6  
Old 06-03-2006, 08:36 AM
Harrison's Avatar
Harrison Harrison is offline
Administrator
 
Join Date: Oct 2004
Posts: 6,917
Default

Thanks David! For future reference, members can attach helpful documents.
__________________
"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
  #7  
Old 06-03-2006, 10:42 AM
go*big*red go*big*red is offline
Senior Member
 
Join Date: Jun 2005
Posts: 123
Default

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.
__________________
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.
Reply With Quote
  #8  
Old 06-03-2006, 11:28 PM
LBP LBP is offline
Senior Member
 
Join Date: Aug 2005
Posts: 446
Default

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.
__________________
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
Reply With Quote
  #9  
Old 06-04-2006, 02:55 AM
ans ans is offline
Senior Member
 
Join Date: Mar 2005
Posts: 1,596
Default

Thanks for sharing your website.

ans
__________________
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.
Reply With Quote
  #10  
Old 06-06-2006, 05:32 AM
Eddie_G's Avatar
Eddie_G Eddie_G is offline
Senior Member
 
Join Date: Apr 2005
Posts: 238
Default

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...
__________________
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
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



All times are GMT -4. The time now is 02:42 PM.


© Copyright 2006-2017 ADRSupport.org All rights reserved.