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Insurance Issues Discuss Any success with United Health Care covering Cervical ADR in/out of US? in the Main forums forums; Has anyone been approved for ADR coverage through UHC within US or in Germany? I've been denied within US ...

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Old 06-13-2010, 06:48 PM
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Question Any success with United Health Care covering Cervical ADR in/out of US?

Has anyone been approved for ADR coverage through UHC within US or in Germany? I've been denied within US as of now, but haven"t yet applied for refund of cost if I elect to go to Dr. Bertanolli in Germany. My doctor says he does not recommend a 3rd cervical fusion (C4-5) due to his projection of the rate of degeneration of C3-4 if atop a 3rd fusion. My C5-6, & C6-7 fusions are 14 years old. I am going for consult for Cervical Spinal Cord Stimulator this week to try to get some relief to 'buy' time and reduce amount of pain meds. Please respond if you've had experience with insurance coverage.... either US or abroad OR had experience with Spinal Cord Stim. Thank you. Thank you Justin for providing this opportunity. I hope good health to all!
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Old 06-14-2010, 04:07 AM
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Bellesey,

I don't know about luck with UHC, but you have a double whammy. In addition to the usual problems getting ADR approved, you are "off label" with your prior fusions.

IMHO, spinal cord stimulators are what you try when you have run out of options. There is no free access to the spinal canal and implanting the leads may have some unintended consequences further down the road.

Mark

PS... Justin is over at Spine Patient Foundation.
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Old 06-15-2010, 06:08 PM
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Smile Thank you Mark.... Any thoughts?

Thank you Mark. You have truly made a difference in my life at this challenging time! Sounds like I need to give this a lot of thought (SCS) before my appointment on Thursday to get evaluated.

Dr. Bertagnoli's US rep, said he does do the ADR above a fusion, but my doc (Dr John Small) here in Tampa who was appealing my insurance on my behalf, doesn't know if the replacement disk will resolve my pain. He (Dr Small), told me a couple of visits ago, that a woman in Lakeland,FL recently had the very surgery he has been considering for me.

My thinking is to move on the SCS (not knowing of the risks until just now), and if it works, I can buy some time before 'testing' the ADR adjacent the fusions.

Any thoughts? I've been getting increased right shoulder and leg "twitching/jerking". Is this a common occurrence?

I don't feel I have enough information (and I've researched) to made an educational decision.

Again, thank you!
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Old 06-17-2010, 03:26 AM
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Bellesey

I too have UHC (the worst) and need cervical multi-level surgery. In researching this I've learned that this is an area in medicine with great disparity in knowledge and expertise among doctors in the us. you should asssume there are options out there you havent heard of.
There is a surgeon in Delray Beach FL that is young, fairly up to date , and does multi-level cervical adr. If I were you I would forget any assumptions I have and simply ask things like whether it is possible to unfuse vertebrae in order to insert an ADR.
if youre interested in the Dr he is:

Edward H. Chung
Spine Institute of South Florida
5210 Linton Blvd.,
Suite 103
Delray Beach, FL 33487

(561) 381-4271
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