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Reply With QuoteUnbelievable. Why on earth are these insurance companies not on the leash. What is the point of even having qualified doctors.
Sorry to hear it Missy. I suppose you've got to go through the appeals process now?
This is a discussion on Anthem strikes again! within the Health Insurance forums, part of the Insurance and Travel Forums category; Well, my new ins co, Anthem of CA, has decided in their greedy way, that my surgery is unneccesary! I ...
Anthem strikes again! Well, my new ins co, Anthem of CA, has decided in their greedy way, that my surgery is unneccesary! I guess 2 doctors who have actually spoken to me and looked over my case are not competent to decide what is the best care for me! I sure wish I had gone to the industry hack! Maybe he could have "cured" me with his unknown voodoo! Boy am I thrilled that I have already done my pre-op EKG, blood work and x-ray before they ceremoniously decided that I don't require surgery! WOW! I guess the crap I've heard about Anthem is all true. We can make money with the "deny, deny, deny" practice of medicine!
Multiple spinal surgeries (10) beginning in 1982. Fusion L4-5 (1992), Dyneses rods after stenosis surgery L3-5 (2006). Fusion C6-7 (1993) and C5-6 (1999), Foraminotomy C4-5 (2008). Current problem L5-S1. MRI doesn't see anything, but the pain is consisitent to L5-S1.
Re: Anthem strikes again! Unbelievable. Why on earth are these insurance companies not on the leash. What is the point of even having qualified doctors.
Sorry to hear it Missy. I suppose you've got to go through the appeals process now?
Re: Anthem strikes again! I'm sorry, that sucks. Assuming you are appealing?
31 years old- 1/06- In wreck with 18 wheeler at 25 years old; 6/06- Head on collision on Interstate, both wrecks other drivers fault. Numerous MRI's, PT, chiropractic, acupuncture, TENS therapy, massage therapy, facet injections, epidural injections, Nerve study, Discogram, confirms pain in L4/5, IDET, decompression, Bi-lateral neurotomy L3/4/5, denied by insurance twice, in Active L clinical trial, had surgery March 17, 2009 in Miami, FL- received Active L disc at 29 years old. Pain and medication free as of October 2010!Mommy to Emma- 8 years, Ava- 6 years & had baby Eli after ADR, via c-section on March 25, 2011, completely pain free still!
Chris. Yeah it's really unbelievable. Yes, I'm now looking into the appeal now. It's not like I'm asking for ADR!
Having to appeal is such a joke! I have 2 doctors saying this is neccessary and their idiot, who has never even spoken to me, says NO GO! Will keep you posted.
Re: Anthem strikes again! Originally Posted by mmarsh
Well, my new ins co, Anthem of CA, has decided in their greedy way, that my surgery is unneccesary! I guess 2 doctors who have actually spoken to me and looked over my case are not competent to decide what is the best care for me! I sure wish I had gone to the industry hack! Maybe he could have "cured" me with his unknown voodoo! Boy am I thrilled that I have already done my pre-op EKG, blood work and x-ray before they ceremoniously decided that I don't require surgery! WOW! I guess the crap I've heard about Anthem is all true. We can make money with the "deny, deny, deny" practice of medicine!
mmarsh, this is beyond frustrating.
It is all about deny, deny, deny like you said. Insurance companies dictate healthcare in America--we should be upset with the insurers, but many are directing their anger at the smoke screen of rationing care, gov't take over, etc. and not the real, big elephant in the room: insurance companies.The conversation needs to include the mafia-esque insurance companies.
Sorry, I'll step off the soapbox now.
Fight tooth and nail. Give them hell.
Justin Averna
Founder & President, Spine Patient Society™
www.SpinePatientSociety.org
A 501(c)(3) Tax-Exempt Nonprofit & Charitable Organization
I'm here to help.
- 1994: Football Injury, Severe Hyperextension
- 1997: Snow Skiing Injury
- 3/7/1997: Laminotomy L4/L5
- 1999 & 2003: Motor Vehicle Accidents (not at fault both times) --> Grade V Annular Tears L4/L5 & L5/L6
- 11/15/2003: 2-Level ProDisc® L4/L5 & L5/L6*, *lumbosacral transitional vertebra --> Dr. Rudolf Bertagnoli
- 4/2008: 4.5 years pain-free before "new" leg pain
- 5/14/2009: Dynamic Stabilization System L4/L5, Dr. Rudolf Bertagnoli
Questions? Suggestions? Need help with registering, creating a signature, etc.?
justin (at) spinepatientsociety.org
Disclosure: I have no financial relationships with any surgeons, spine clinics, device manufacturers, pharmaceutical companies, hospitals, etc. -- the SPS Board of Directors serve without compensation.
Re: Anthem strikes again! I completely agree with Justin's post. It's just a complete scam!
mmarsh, this is beyond frustrating.
It is all about deny, deny, deny like you said. Insurance companies dictate healthcare in America--we should be upset with the insurers, but many are directing their anger at the smoke screen of rationing care, gov't take over, etc. and not the real, big elephant in the room: insurance companies.
Sorry, I'll step off the soapbox now.
Fight tooth and nail. Give them hell.
• January 2000 MVA passenger, used jaws of life to retrieve me, neck injury and months of PT
• June 2001 Bicycle accident, 2 compression fractures at T12/L1, Vertebroplasty Sept. 2001
• April 2006 right hip, labral tear and repair
• April 2007 3 level ProDisc @ L3/4, L4/5 & L5/6✷ ✷Lumbosacral transitional vertebra; Dr. Rudolph Bertagnoli
• July 2, 2008 ALIF & Laminectomy @ L6/S1
• July 30, 2008 re-opened 28 days later to remove bone cement that had leaked onto S1 nerve root
• August 2008 Pulmonary embolism, double pneumonia, collapsed left lung, re-hospitalized 1 week
• March 10, 2009 Right SI Joint Fusion
• April 27, 2010 2nd right hip arthroscopy to remove adhesions and release psoas muscle
• September 30, 2010 lumbar facet rhizotomy
• December 9, 2010 12 bilateral lumbar trigger point and steroid injections
• December 23, 2010 12 more bilateral trigger point injections w/o steroid
• February 15, 2011 ESI bilaterally in lower lumbar...relief only for few days. Considering 1 more.
Did Spinal Cord Stimulator trial from 5/11/11-5/17/11 with excellent results; Spinal Cord Stimulator surgery is Monday,
July 18, 2011
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