Upcoming surgery w/Dr Zeegers

[henry4956]

I am doing very well. ALmost never think about it anymore. Not doing anything crazy though. Walk 2 x day, Swim 3 x week. No Percocet!

My coccyx which is unrelated still aggravates me, but what can I do, it's been 13 years so I'm kind of used to not being able to sit for more than a few minutes.

I had lost all hope and was in deep despair for 3 years and I'm loving life again -thanks to Dr Zeegers and a little inspirational talk I had with Mark.

[vnf]

Henry

Glad to hear things are improving.
I just had injections today in the SI joint because of that same tailbone area pain.
Dr. Zeegers told me that it's probably referred pain from the lumbar area and not the SI joint.
You probably just need more time for your muscle's to relearn where they are supposed to be and actually learn to relax again.
Don't over do it.
Remember that gel pack is your BFF!

Glad to hear you are improving

[henry4956]

Thanks Vicki, really think about you a lot. Don't know if my coccyx will ever normalize, but I cant emphasize enough how much better life is without that awful low back pain

[Maria]

Sounds like you're doing great! With that activity schedule I'd be back in shape in no time Keep up the good recovery!

[henry4956]

I have never been involved in such a messed up, bureaucratic situation. So far they have requested several documents a 2nd and 3rd time and assigned a 2nd case # to my case.

When I talk to the reps at the international phone #, they keep telling me my case is still pending. I was able to have Dr Zeegers fill out a 'Letter of Medical Necessity' that I drafted and which they requested.

The 2 times I called my local BCBS they tell me verbally that because it was 'planned' and not a emergency like a car accident that I am denied. Yet when I ask for a formal denial, they just pass over it and tell me I can appeal. That is nonsense. I will not appeal something in which I have no official letter of denial. Especially when the International people tell me my case is still being considered.

The one good thing is that I've never heard anyone tell me anything about the procedure itself being 'EXPERIMENTAL' like so many others who are denied.

I really think if I just keep after them, one day someone is just going to stamp it 'APPROVED' and pass it on because they want to keep their desk clean.

Stranger things have happened.

[vnf]

Henry

When I called BCBS Worldwide, I told them that I was going for a planned surgery and would I have any benefits for that.
The guy asked me for my member # and said "yes, I do have benefits".
I specifically said "even though it's a planned surgery and I'm not there vacationing and something accidental happens". The guy said yes, I have benefits but a pre authorization has to be done by the clinic.
The guy gave me a case number and I'm supposed to call them back when I have a surgery date. That's as far as I've gone.
I have not called back yet to see what happens next.
I know that just because he says "I qualify for benefits" doesn't mean that they will approve anything.
I'm going to try and get it covered too.
I'm pretty much feeling like US or Germany won't matter and they will still try to deny it for any reason they want to dig up.
I hate them! It's very frustrating.

[henry4956]

Got my 1st official denial today. It was on the basis of not meeting 'medical necessity' criteria. I actually think I will eventually win. If their denial was based on the 'experimental' explanation I would be more discouraged.