before paying for the screw
That doesn't sound right. If the surgery was approved even if it was after an appeal and the screw was an integral part of the hardware to be utilized it would seem that there would be a good arguement for payment there.
Now if the doctor wanted to use a screw that was not commonly utilized or perhaps one made of platinum or gold vs. standard grade screw material maybe I could see that getting denied.
Of course I agree w/Mark re the revamping of this whole approval/denial thing esp. as you mentioned after the fact.
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