Quote Originally Posted by jss View Post
What I'm seeing is people complaining on these sites that BCBS-TX will not pay for their ADR. BCBS-TX approved my ADR in 2008; I had the surgery in 2009, and then they declined the claim after the surgery. So from what I'm seeing is that they are not paying. However, someone for whom BCBS-TX refuses to pay is more likely to be on these forums.

IF BCBS-TX really does tend to pay, I can't tell it by reading these forums.
It's just downright criminal as to what the insurance companies get away with. I agree to a certain point that our healthcare system needs some changes....this being a perfect example. I'm so sorry you were mislead like that and stuck with the bill in the end. Are you fighting the insurance company to get them to reimburse you or pay for the claim?

"However, someone for whom BCBS-TX refuses to pay is more likely to be on these forums."
As sad as it is I agree with you on that one. It seems like the people who get fair and ethical treatment and the surgery they needed/deserved dont have to battle all the hassle and issues we do therefore dont have as much of a need to post about it on a forum.....I wish more of them would come by like others who have to tell us about how they had a 3 level ADR and 3 years later their great or a 4 level fusion and 2 years later their pain-free.