SpineNation Group - Artificial Disc Replacement

JennieSally2020

3m

Need some help navigating the appeals process for ADR. This is for ADR L5-S1, degenerative disk disease that is now a ruptured disk, in Washington state and my insurance won't cover due to it being "experimental". Does anyone have any tips or additional study data? We have submitted numerous studies on the five year success rate, and I submitted medical policies from three large insurers that cover this. I also included legal actions that ruled in favor of the patient to cover this procedure, because the burden of proof is on the insurance company to prove it does not work. Spinal fusion was also denied by them, mainly because they did not read any of the pre-approval request and rubber stamp denied that (met all previous care requirements: PT, injections, manipulations, etc). I feel like I am fighting an uphill battle I cannot win. Spinal fusion is a scary alternative but numerous consultations have said no other treatments will work for this.

3 Comments

Save Cancel

DonnerLake

3m

Hi chief Backer - going do a consultation with Blumenthal next week. I just had one with the group called Balanceback that does surgery in Cayman Islands? Do you have any knowledge of this product and doctors? And has anyone had this surgery done using their product? Thanks

2 Comments

Save Cancel

Group Description

Group dedicated to discussions about lumbar and cervical disc replacement, surgery, recovery and support.

Artificial Disc Replacement

JennieSally2020

3m

DonnerLake

3m

Group Description

Group Members

Admin

All Members

Member Requests