I recommend you speak to surgeons about their experience getting surgery authorized by insurance companies. The surgeons I consulted spontaneously told me about differences in insurers, in terms of which ones can be persuaded to authorize ADR, even at multiple levels. If you have a choice of insurance companies, and don't have pre-existing conditions excluded, or treatment for them delayed for a long time, find out which ones the doctors like to work with the most.
Sandra



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