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iSpine Discuss Blue Cross Payment 3-level Activ-L in the Main forums forums; Mark, I'm very interested about the $8,000.00 amount. Are you saying that was his cost for the ...

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Old 11-19-2006, 12:58 AM
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Join Date: Nov 2006
Location: Kodiak, Alaska
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Mark,

I'm very interested about the $8,000.00 amount. Are you saying that was his cost for the surgery? I am really looking forward to speaking with the patient who had surgery with Dr. Zeegers. See you tomorrow. Eric

P.S. It's still blowing , but only at 30 to 40 mph. It's about 22 degrees out so it has warmed up. It's supposed to blow 60 tomorrow so I am leaving just in time. I'm not looking forward to the turbulence tonight. It's supposed to be bumpy all the way to the west coast. My back will be a mess when I get to L.A.
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Old 11-26-2006, 03:30 AM
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Join Date: Nov 2006
Location: Los Angeles, California
Posts: 9
Default Blue Shield

Mark,

As you know Blue Shield intially paid for my Charite surgery in 2005 then rescinded payment 6 months later. I hired a lawyer and fought them and got them to change their minds and give the money back. So in the end, Blue Shield (Washington state) paid for my Charite in full.

I was out a few thousand in legal expenses, but it sure beat paying $50k (maybe more). My situation was very unique, as the case centered around the pre-certification (which they pre-certified). Blue Shield argued it wasn't done correctly and so had the right to reverse the claims and rescind payment. It was a long drawn out painful process, but I am glad that I prevailed.

Dan
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Old 11-26-2006, 08:47 AM
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Join Date: Sep 2006
Location: Ohio
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Mark,

I believe that insurance companies are beginning to "warm up" to the idea of sending patients abroad for procedures because they .... well lets face it....cost less. I will try to find the article. I think I know where it is at.

I will come back and post the link....
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Old 11-29-2006, 04:20 PM
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Join Date: Sep 2006
Posts: 2,405
Default here's hoping

That I can get WCAB CA. to pay for surgery abroad. I'd happily pay airfare, Mark's costs and so forth just to get the surgery and stay covered which quoted for 3 levels is nearly half of what a hybrid (ADR and fusion) at 2 levels would cost where I've been here in CA.
My plan is submit cost estimate of everything and info re follow up doc (not secured yet) and hope that WC can see that they'd save a pretty good sum of $$ yet be sending me to one of the most experienced spine surgeons doing ADR. If not this, than probably one of most experienced spine surgeons here in U.S. which WC is working on currently~
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Old 11-29-2006, 04:31 PM
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Location: Southern California
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Maria, I think we have met...maybe about four or five years ago, in a park in Huntington Beach. Cervie Queen, Mark, and others were there, too. We walked and had lunch.

I am also a WC patient and faced with a two-level ADR. Could you please share your WC journey with me? I am going to see an attorney today and would like to jumpstart the approval process. My e-mail address is AguilarKL@aol.com
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