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MY Insurance is denying my surgery:(

AnonymousUserAAnonymousUser Posts: 51,489
edited 06/11/2012 - 8:19 AM in Back Surgery and Neck Surgery
I just wanted to get some opinions and some support about this.....

I found an AWESOME!! Spine surgeon in the Denver area....I went to him..showed him my latest MRI and he says that I need a level 2 spine fusion done....YEA....I can finally get some relief....NOW my insurance..not WC or someone elses insurance..but MY insurance is denying the surgery...I want to scream at them and tell them if you had to walk in MY body for a week you would scream too!!!

My pain has gotten sooo much worse since my 2nd ESI..I think that Doc hit the disc;(

So now I am trying to find out what I can do to get my insurance to change there minds.....I really need this done...any suggestions???
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13

Comments

  • is terrible news. I am so sorry sweetie. Is there an appeal process that you can do and if so have you started it? I hate to say this but you may even end up having to see a lawyer about this if it gets too bad.Please keep us posted as to what happens. I wish you the best of luck....take care...Miki
  • I am waiting now to see if my surgeon can convince my insurance to get off their A%# and help me...I should hear from them today...I had to break down and tell my Doc of the bladder problem that has come up:(:( HOW embarassing:(:(:( :jawdrop:

    I am only 35 and I feel alot older and my MOM just told me it was pretty much all in my head;(:(:( I am soo down right now!!

  • Hi

    My wife and I have to fight the insurance people often.

    Good Luck to you.

  • am so glad that your doc is helping you with this. Also , don't be embarassedabout telling your doc things. Remember he hears stuff like that every day sweetie and it is info that he needs to have to be able to treat you properly. I will be praying for you hon....Miki
  • I dont really know why its being denyed...they said THEY dont think that I need the surgery:( Well if they could feel what I feel then they wouldnt say that!!

    I just dont understand and its driving me crazy :?
  • Your doctor has a lot of pull, and if he thinks you need the surgery, he will likely write a strong appeal letter on your behalf. You may want to obtain a 2nd opinion from another surgeon, so that you have a stronger case. Try not to worry too much. It is difficult to have patience when we are in pain, but if your surgeon fully believes you need this surgery, he will fight for you.

    Sorry for your pain and frustrations.
    Surviving chronic pain one day at a time, praying for a reprieve because living another 40 years like this doesn't sound too fun!
  • Thank you Neck, I really appreciate that:):)

    I would get a second opinion but I am SOOO broke that I dont have the Co-pay:(
  • I just went through this. I know how scared you are. Hang in there. I am sure your surgeon will be able to convince the insurance company that you need the surgery.

    I ordered my records pertaining to the request from my Insurance Co so I could personally go through the request and I wasn't surprized by my decline because the information that the insurance co sent to the outside md-(for the approval) was missing some important information.

    My insurance offered a peer review- the NS called the MD with the insurance and they spoke about it.
    I received my approval yesterday. ;)

    Hang in there,

    Julie
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