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What kind of documentation do I need to be approved?

Hi all!
I'm scheduled for ACDF surgery for C6-C7 on October 24 after a year of pain and conservative methods. I'm waiting to see if I will be approved but I'm a planner and like to be prepared for the worst. We just recently moved to TX and got new jobs with new insurance and new doctors. My new doctor never asked for records from previous doctors or physical therapists or anything like that just simply went over my history of what I have tried, what has worked, what hasn't worked, ect. And then based on my pain level and my MRI he decided that surgery was my best option. From what I understand my insurance requires "documentation of conservative treatment". I have a PPO if that helps. Is that documentation simply him telling them what conservative methods I have tried or do they need all the records from all my previous doctors and Physical therapists?  Any input and personal experiences would help a lot. 


  • SavageSavage United StatesPosts: 7,270
    I think all insurance companies are so different.
    I would talk to doctor about what your insurance requires and see if he can accommodate you with your history.
    Honorary Spine-Health Moderator
    Please read my medical history at: Medical History

  • dilaurodilauro ConnecticutPosts: 13,434
    Sue is correct, each insurance company has different requirements.  Some will approve a surgery based on the surgeon's notes.
    But the last thing you want to run into is insurance denying your surgery when its October 23rd
    Ron DiLauro Veritas-Health Forums Manager
    I am not a medical professional. I comment on personal experiences 
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