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  #1  
Old 06-27-2005, 01:02 AM
BRENDAWY BRENDAWY is offline
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I was so excited to find this forum. I have been visiting for some time now and have gotten a wealth of information. I have torn, herniated l4-l5 and l5-s1. I just turned 33 in November. I have been fighting back pain for 7 years. In may of 04 I had l4-l5 laminectomy and was told to hold out for a new disk. My surgeon wont even request the adr with ins. because he found out they wont cover it.He called and said lets just fuse you. No way! I called another surgeon and tried to get a second opinion. When he found out who my ins. was I got the same response. I said no, so they wont even see me. I explained to both offices that I have the right to be denied and the right to an appeal. They dont care.Its been 3 weeks since my disco gram and no surgeon in my town will precert the adr proceedure even though they are trained to perform it. I am now sceduled to see a Dr. in colorado. He is four hours one way and the drive will kill me. However they know of my delema and will help me through the appeals process.I know this post is long winded, I will post again tonight under we need numbers of adr waiting. I have alot in the works for the Ins. co. and cant wait to share it with everyone. BrendaWY
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Old 06-27-2005, 03:14 PM
bmills bmills is offline
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BrendaWY: What doctor are you going to see in Colorado?

Brady
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15+ yrs chronic low back pain.
L5/S1 DDD
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  #3  
Old 06-27-2005, 03:32 PM
BRENDAWY BRENDAWY is offline
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I am going to the Rocky Mountain Associates at Loveland Surgical Center, Dr. Donner is who I will see on Thursday. Do you Know anything about him? BrendaWy
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Old 06-27-2005, 05:58 PM
bmills bmills is offline
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I have been to the same location and saw doctor Kenneth Pettine. He is a partner with doctor Donnor. I liked Pettine a lot and think he is a talented doctor. I don't know much about Donnor but I think the practice is a good one. Accoring to doctor Pettine, it sounds like Pettine has done more ADR's than Donnor. I'm not sure how important that is.

Please let me know how your visit goes.

Brady
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15+ yrs chronic low back pain.
L5/S1 DDD
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  #5  
Old 06-28-2005, 01:03 AM
walker walker is offline
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Join Date: Mar 2005
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I am fighting BCBS of Oklahoma. I was denied my precert in early March. During the first appeal that my doctor was submitting, his office was finally told to "just hold off till July 1, 2005 because that is when the newly adopted AMA codes will be recognized by the insurance company." It seems that the codes currently used are not specific to the process of ADR. BCBS didn't say they would accept my precert at that time, they just said to wait and use the new codes. Maybe this is good, I don't know yet. Good luck with your fight. You are on the right track: take control of your health, become as informed as you can be, don't settle for something you don't want, and most of all--never give up!!! Welcome to the family.
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Old 06-28-2005, 06:57 AM
BRENDAWY BRENDAWY is offline
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That is good information to have. I will look into that here . The only one who will take care of us is ourselves. I am my best advocate and I wont settle. Im going to beat this. Thank yopu for your support, Brenda Wy
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