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3-level lumbar ADR overseas paid by one of the Blues!
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| iSpine Discuss 3-level lumbar ADR overseas paid by one of the Blues! in the Main forums forums; I spoke to a client a few days ago who recently received a check covering a SUBSTANTIAL portion of the ... |
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02-25-2010, 01:05 AM
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3-level lumbar ADR overseas paid by one of the Blues!
I spoke to a client a few days ago who recently received a check covering a SUBSTANTIAL portion of the surgery!
I can't write more now... but this is great news! Perhaps a breakthrough for both overseas and local ADR coverage? Mark
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1997 MVA 2000 L4-5 Microdiscectomy/laminotomy 2001 L5-S1 Micro-d/lami 2002 L4-S1 Charite' ADR - SUCCESS! 2009 C3-C4, C5-C6-C7, T1-T2 ProDisc-C Nova Summer 2009, more bad thoracic discs! Life After Surgery Website President: Global Patient Network, Inc. Founder: www.iSpine.org 
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02-25-2010, 02:49 PM
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re the check
Hey Mark,
When you can please write more on this. I'm guessing this is an insurance like Aetna or BCBS or something and not WC however still very interesting. Maybe they're (the insurance co) getting it that *outsourcing* is significantly cheaper.
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02-25-2010, 08:21 PM
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Coverage
Good to know....I may be heading back soon for more diagnostic work; I'm sliding downhill these days.
-Jeff
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19+ years back pain w/ advancing disc degeneration. 2002-2 level lumbar IDET w/ Nucleoplasty (very unsuccessful; huge setback) Three level lumbar Charite (L3/4, L4/5, L5/S1) with Dr. Zeegers in Munich, Germany: 2/25/05 (successful) Two level cervical Mobi-C (C5/6, C6/7) 2/2/07 with Dr. Zeegers (successful) Laser Facet Coagulation (left side: L3/4, L4/5, L5/S1 & sacral) 11/04/10 with Prof. Dr. Reul / Beta Klinik (significant reduction in remnant lumbar & sacral pain)
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02-26-2010, 07:41 PM
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do you think I can get a retroactive reimbursement from 4 1/2 years ago
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3 level Prodisc adr S1-L3, Oct 12, 2005 Dr. B in Bogen, Germany Severe nerve damage in left leg, still working on it
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02-26-2010, 08:24 PM
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blues
I've got BCBS of Tx which seems to be better to work w/than BCBS of MA. that I had before re hub's work insurance coverage tho it does not cover my low back unfortunately and even has tried to deny coverage on my cervical spine (spinal issues period). Can't do this tho as WC only covers low back.
Dale, I wonder what the statute of limitations is on your case. Have you tried to appeal non payment? I think the Blues are diff from state to state or that was my experience w/BCBS of Mass being covering less than BCBS of TX nto to mention Customer Service w/ BCBS of Tx is really good vs. the other I had. Great to hear about the coverage and I wonder how they arrived to that conclusion of payment overseas unless injury took place there? Just a good outcome most definately.
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02-27-2010, 02:51 AM
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This is a good thing!!!
This is a good thing. I sometimes feel like we are doomed as spine patients. I am so happy for whomever this person is. That is absolutely awesome for them!
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BI lateral pars fracture repair for isthmic spondylolythesis on l5 10/2/07. success for about 1.5 years. Hardware began to fail,  so on to the wonderful world of fusion l5-s1 2/15/10 By the wonderful Dr Frank Coufal. Great so far let see how good this will work!!
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03-02-2010, 06:40 PM
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Imho
I found in my research that BCBS in different states paid for surgeries here and abroad. I sincerely hope they change coverage positions to cover lumbar and cervical. But, I am not optimistic. BC of Montana covers lumbar ADR and one in another state covers cervical (can't recall which state right now). The BCBS policy omits three major studies that are in favor of ADR. Nothing they do makes any sense, except for their greed to make money by hurting their customers.
Congrats to the person who got this covered.
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