Got my answer to my insurance appeal...

[Justin]

Kathy,

This is complete BS. Do you happen to have the booklet for your insurance plan? I would look into the issue of age they brought up within the booklet. There should be a generic statement about persons treated under your plan.

I know it takes a lot of time and energy to appeal again, but I would--this was only the internal appeal and it is loosely put together considering they only have one reference to a study. I would request the clinical rational and guidelines they used to come to their determination. Also, investigate who came to this determination and what this person's credentials and background are (speciality, state of practice, etc.)

This is ridiculous... you need to throw study after study at them regarding subsequent revisions after the "gold standard" operation fusion.

If you need any help, let me know.
-Dr. J