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iSpine Discuss 3-level lumbar ADR overseas paid by one of the Blues! in the Main forums forums; Good to know....I may be heading back soon for more diagnostic work; I'm sliding downhill these days. -Jeff...

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Old 02-25-2010, 07:21 PM
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Location: Southern California
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Default Coverage

Good to know....I may be heading back soon for more diagnostic work; I'm sliding downhill these days.
-Jeff
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19+ years back pain w/ advancing disc degeneration.
2002-2 level lumbar IDET w/ Nucleoplasty (very unsuccessful; huge setback)
Three level lumbar Charite (L3/4, L4/5, L5/S1) with Dr. Zeegers in Munich, Germany: 2/25/05 (successful)
Two level cervical Mobi-C (C5/6, C6/7) 2/2/07 with Dr. Zeegers (successful)
Laser Facet Coagulation (left side: L3/4, L4/5, L5/S1 & sacral) 11/04/10 with Prof. Dr. Reul / Beta Klinik (significant reduction in remnant lumbar & sacral pain)
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Old 02-26-2010, 06:41 PM
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Location: Los Angeles
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do you think I can get a retroactive reimbursement from 4 1/2 years ago
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3 level Prodisc adr S1-L3, Oct 12, 2005
Dr. B in Bogen, Germany
Severe nerve damage in left leg, still working on it
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Old 02-26-2010, 07:24 PM
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Default blues

I've got BCBS of Tx which seems to be better to work w/than BCBS of MA. that I had before re hub's work insurance coverage tho it does not cover my low back unfortunately and even has tried to deny coverage on my cervical spine (spinal issues period). Can't do this tho as WC only covers low back.

Dale, I wonder what the statute of limitations is on your case. Have you tried to appeal non payment? I think the Blues are diff from state to state or that was my experience w/BCBS of Mass being covering less than BCBS of TX nto to mention Customer Service w/ BCBS of Tx is really good vs. the other I had.

Great to hear about the coverage and I wonder how they arrived to that conclusion of payment overseas unless injury took place there? Just a good outcome most definately.
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Old 02-27-2010, 01:51 AM
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Default This is a good thing!!!

This is a good thing. I sometimes feel like we are doomed as spine patients. I am so happy for whomever this person is. That is absolutely awesome for them!
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BI lateral pars fracture repair for isthmic spondylolythesis on l5 10/2/07. success for about 1.5 years.
Hardware began to fail, so on to the wonderful world of fusion l5-s1 2/15/10 By the wonderful Dr Frank Coufal. Great so far let see how good this will work!!
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Old 03-02-2010, 05:40 PM
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Default Imho

I found in my research that BCBS in different states paid for surgeries here and abroad. I sincerely hope they change coverage positions to cover lumbar and cervical. But, I am not optimistic. BC of Montana covers lumbar ADR and one in another state covers cervical (can't recall which state right now). The BCBS policy omits three major studies that are in favor of ADR. Nothing they do makes any sense, except for their greed to make money by hurting their customers.
Congrats to the person who got this covered.
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