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Having Panic Attack/Surgery for 8/6 Denied

AnonymousUserAAnonymousUser Posts: 49,671
edited 06/11/2012 - 8:33 AM in Back Surgery and Neck Surgery
My insurance has denied not only the ADR (Lumbar) now per letter I rec today sounds like the have denied the whole surgery

(Sched for fusion L5-S1 and ADR L3-4)
This is only my second post,so Sorry if I am doing anything wrong.

My surgeon Phys Assistant placed call Monday 7/20 to do a Peer to Peer Review with Ins Col. and she hasn't rec. a call back

I have initiated a patient appeal but have not received any call or letter etc.........

I can't stop Crying.I am so deeply upset I don't know what to do.
I think I finally find someone to say I meet prtocol for surgery and now this
I have been on this road since appro 1999 when I had 1 Lumbar herniation/DDD
Now have 3 herniations grade -5 annular tears with leakage of ontrast material per discogram at 3 levels....

I have grinned and beared it for the last 10 yrs have done Chiro,PT,pain meds,muscle relaxers.Epidural steroid injections x 5

I have LBP and bilat leg radiculopathy
I cannot sit I cannot walk too much I have been out of work since 6/2

Is there a chance that my surgeon office can change my inurance comp's mind? before surg which is in 2 wks from now

Any help/advise appreciated




  • Would they allow you to have fusion at both levels? I think many companies are now denying ADR surgeries.

    I would think your surgeon's office would deal with this for you.

    Maybe you could keep calling your insurance company until you receive the information you need.

    Hopefully others who have been through this will post with their suggestions.

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