Blown Away

Many of you who have been following my blog for any time know about my problems with insurance. My doctors have made one recommendation and my insurance company won't let them do it. It has gone through a ton of official channels. They denied coverage for the spinal cord stimulator and the doctors didn't like the reasons so they changed some of the notes around, but insurance would not budge. The next thing was the official appeal process where I wrote a short letter and asked that it be reviewed. They reviewed my appeal and denied it again. The next one was an in-person appeal and I was getting desperate so I wrote a couple of pages for the appeal, my wife got someone to watch the kids and we, along with some close friends, went there in person. We spent 45 minutes going through with them what it is like and what I'm experiencing. There were five of the insurance people in the room and two of them were in tears along with all of us. Then, a few days later, they called to tell me that they continue to deny the procedure. That left me with the last appeal. This one is reviewed by a group of people who are not employed by my insurance company, but I do not have the opportunity to meet them in person. So my wife and I spent nearly a month writing and rewriting the letter to them. My doctor sat down with me for almost an hour to review his notes and get his letter to say what we wanted. So my doctors five pages of notes and my four page letter went to this external review. While I hoped it would go through, I really didn't expect it to go through, so I continued to work with my HR department to see if one of the other insurance offerings would pay for the procedure. So today I received a call from the insurance company...the external review approved me! They are going to put a spinal cord stimulator into my back and see if it makes any difference in my pain!