Tuesday, July 8, 2008

ADR surgery scheduled

I finally spoke to Joanna the surgery scheduler for Dr. Delamarter, and we have pencilled in Tuesday, September 2 for my two-level disc replacement. She reminded me a few times that Blue Cross (BC) would likely deny the procedure, but I told her I wanted to get the ball rolling. She twice asked me if I had sufficient funds to pay out of pocket, and I told her I did not. [I want them to give maximum effort towards getting Blue Cross to approve.] She informed me that BC would respond within a week, likely with a denial. Then I could appeal the decision in writing. After that, BC has up to 30 days to process the appeal and render a final decision. So, the process has begun. I feel at peace moving forward as I've tried everything else, and my back is not getting better. If anything, it seems to be getting worse, with more pain concentrated on the left side of my low back. It's time to do something. The other factor is the insurance issue. Supposedly Kaiser will approve an ADR. But I only have that brief once-per-year window of opportunity to change insurance in October, to be effective January 1. So, I need to know before then whether or not Blue Cross is going to approve the procedure. And if not, then I'll have another big decision to make: $50,000 for the best (Delamarter) or back to Kaiser for free.

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