Kerry, it is insane. For the first 9 years I did this, we were frustrated because the insurance company would not pay for ADR. Few have been successful... many more for one level procedures, very few for more common multi-level cases. Cervical ADR was adopted quicker, but many companies will not pay for anything if the term ADR is anywhere nearby... even for hybrid surgeries that are one level fusion w/one level ADR.
Lately, they are even more emboldened and are denying more traditional surgeries like fusion.
As long as the politicians continue to write laws beneficial to industry, even when the industry is completely unreasonable (eg: when they literally deny everything and make the doctor's offices go through a very laborious and paper-intensive process, just for ordinary treatments!), we will be powerless to fight the nonsense. Actually some will fight and win... many, many more will fight and lose; and most won't be able to fight the system. How sad. IMHO, anyone who thinks that the status quo for our medical system is acceptable and reasonable is not well informed about the egregious abuses of the industry.
Having worked for over a thousand spine patients now, I have seen many lives ruined because they don't have insurance, or they have insurance and they deny needed treatments (that all the patient's doctors see as appropriate) and because the patient gets FORCED to accept the wrong treatment because their insurance won't pay for the more appropriate treatment.
We are not talking about wacko experimental procedures. We are talking about something that was FDA approved in 2004!!! They still are allowed to say, 'it's experimental.' That is just BS.
End of rant.
Mark
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