It seems my insurance company would rather spend more trying other stuff before we get to a procedure we know works.
Spouse had this procedure 4 times over the last 12 years.
Had severe back issues and had gone though the typical steroid, cortisone, patches, Lyrica, physical therapy etc. Those never gave much relief until a Dr did the RF Libation procedure which was like a miracle. 2 years relief. The 1st time, it went through insurance with no issues. Was 2008 so the insurance company policy was different from what I remember.
2nd time had to get pre authorized which took a while but it got done.
3rd, around 2015, it got denied and had to appeal 2 times and then a voluntary 2nd level appeal which finally got approved but ended up being a year later. Turns out the Dr office never got the check either for some reason.
4th time the Dr made her go through 2 rounds of steroid shots and 3 months Phys therapy because that is what the insurance required her to do. We knew 100% that that stuff doesn’t work but they still required it. Waste of money because she still needed the RF.
So she went through all that but even so, the insurance still sent out a denial letter.
Do all insurance companies make it this difficult to get Facet Joint Denervation?
There used to be a doc “SURG.00066” but seems to have been replaced by something.
submitted by /u/guesthost1999
[link] [comments]It seems my insurance company would rather spend more trying other stuff before we get to a procedure we know works. Spouse had this procedure 4 times over the last 12 years. Had severe back issues and had gone though the typical steroid, cortisone, patches, Lyrica, physical therapy etc. Those never gave much relief until a Dr did the RF Libation procedure which was like a miracle. 2 years relief. The 1st time, it went through insurance with no issues. Was 2008 so the insurance company policy was different from what I remember. 2nd time had to get pre authorized which took a while but it got done. 3rd, around 2015, it got denied and had to appeal 2 times and then a voluntary 2nd level appeal which finally got approved but ended up being a year later. Turns out the Dr office never got the check either for some reason. 4th time the Dr made her go through 2 rounds of steroid shots and 3 months Phys therapy because that is what the insurance required her to do. We knew 100% that that stuff doesn’t work but they still required it. Waste of money because she still needed the RF. So she went through all that but even so, the insurance still sent out a denial letter. Do all insurance companies make it this difficult to get Facet Joint Denervation? There used to be a doc “SURG.00066” but seems to have been replaced by something. submitted by /u/guesthost1999 [link] [comments]Read Morer/HealthInsurance