Welcome, Friend!

It looks like you're new here. If you want to get involved, click one of these buttons!

Veritas-Health LLC has recently released patient forums to our Arthritis-Health web site.

Please visit http://www.arthritis-health.com/forum

There are several patient story videos on Spine-Health that talk about Arthritis. Search on Patient stories
Protect anonymity
We strongly suggest that members do not include their email addresses. Once that is published , your email address is available to anyone on the internet , including hackers.

All discussions and comments that contain an external URL will be automatically moved to the spam queue. No external URL pointing to a medical web site is permitted. Forum rules also indicate that you need prior moderator approval. If you are going to post an external URL, contact one of the moderators to get their approval.
Attention New Members
Your initial discussion or comment automatically is sent to a moderator's approval queue before it can be published.
There are no medical professionals on this forum side of the site. Therefore, no one is capable or permitted to provide any type of medical advice.
This includes any analysis, interpretation, or advice based on any diagnostic test

Fight with Insurance or do ACDF

AnonymousUserAAnonymousUser Posts: 49,670
edited 06/11/2012 - 8:28 AM in Neck Pain: Cervical
2 weeks ago, my doctor decided that I needed surgery. C6-7 needs to be fixed. I meet all the criteria for ADR but Cigna is denying it. They changed their policy in December 08 from paying on a case by case basis to deny all. My Doctor has filled an appeal but I do not know how much longer I can hold out for the appeal. I have constant headaches, numbness in the left arm and face, and shooting pain down the right arm. My doctor is fairly confident that if I have ACDF, I will be back within a few years to go up 1 level but does not want to fuse it now as it is not causing symptoms.
Has anybody had any success fighting Cigna in 09?
Should I just go forward with the ACDF?


  • You only know how much pain you can handle. How long will the appeal take to get an answer? Can you hold out that long? If your Dr knows what he is doing and has a really good appeal letter it might me worth the wait.

    I have always said I'll hold out for an ADR over a fusion but if it is an emergency and there is no other choice I would go with a fusion. You can always get an adr later on and hopefully your insurance will be covering adrs then.

    I hope you get an answer soon.

  • Fight! Unless it is an emergency and you will do further damage by waiting. Spinal cord impingement is nothing to mess with. Does your doc say you can wait?

    I had my ADR on Worker's Comp. It took 4 years to approve the fusion surgery and then only 8 months longer to approve the ADR instead of fusion. They kept denying it over and over for any number of reasons. They finally approved it after they ran out of excuses. Good luck!

    No experience with Cigna...
  • RangerRRanger on da rangePosts: 805
    hey fbcoach,
    My concern would be how long you wait till you have permanent nerve damage from the tingling/numbness you are experiencing. I'm not telling you what to do but I waited a little too long and now I have permanent nerve damage to my left hand. I blame no one but myself for this but on the brighter side if I waited even longer for my cervical fusion I would have risked
    the possibility of paralysis and/or incontinence. Please talk to your Dr(s) about these concerns.
  • My MRI is similar to yours. I had a central herniaited with cord compression and stenosis. I wasn't a candidate for ADR because of a prior fusion. I was denied by BCBS for a second opinion. By law you can request an expidited appeal by the insurance company. You must request the appeal with a good strong letter for your case. Include any medical records or progress notes you might have. Include medical evidence supporting ADR vs ACDF. Finally,include delay of their decision may add to rapid deterioration or permanent damage. In ending let them know that you understand they have 3 days to respond to your appeal and fax it to them early in the am. I faxed my letter at 8 am and had my approval in 3 hours. Its worth a try. Attend to this issue fast.I have myelopathy because my compression was left untreated for so long.
    Good Luck, Bethy
Sign In or Register to comment.