Discosure, I remember arguing with my 1st grade teacher about the answer to 2+3…
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Here is another. Iew of the erosion. (Not poo related)
https://s19.postimg.org/3p0jyx8v7/IMG_0348.jpg
My insurance company has refused to pay for the Radio Frequency Abrasion, My pain doctor said he would do it for $500, now they want to do each side for $500. I would prefer not to double the radiation by having to go two separate times. I can spend up to $500 on our medical account, but would have to get permission for the $1,000. I am waiting to hear back from them.
I wonder what the insurance company thinks is another option? Stronger pain medication? Surgery? Implant?
Can you appeal the insurance company’s decision? Here in the UK that often gives a better result?
They are not just rejecting me, they are rejecting the procedure for everyone, saying it is still experimental and not proven to be effective yet. I appealed the last rejection of steroid epidural injections and it was overturned, they were trying to say I did not do lesser treatments, we shot back that I have done chiro and acupuncture. They have paid out around $70,000 since march, so I can see why they would be reluctant…
That must so frustrating for you. Have you asked them re what they think is another option? I can’t imagine you’d let it go without asking them that…
Frustrating plus!
Oh well, onward …
Of course I asked, but the insurance lady was just reporting what she was supposed to say, they just said I would need to meet with my doctor to disscuss another option.
Well going for accupuncture this morning, that usually helps for a couple of hours…
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The problem with RF ablation is it is on an unlevel playing field. Drug therapy needs only show a 30% improvement while interventional therapy (RF Ablation is considered surgical) has to show along term improvement of 50% plus. Despite several studies (5) the evidence fo RF ablation is weak. While some improvement has been noted, every study has confirmed the treatment as being “associated with rare, but serious adverse events” and being linked to only “short term” benefits.
FWIW both my sis and I tried, had it not been at roughly the same time, only the first one of us to try would have had it. My sis experience pain levels that were worse than anything she had ever had and persisted for weeks. She was told that was normal as the nerves died but would work eventually(it didn’t) I was told to expect the increase pain levels Instead I ended up paralyzed from the waist down and incontinent for almost a week, not to mention the spinal leak (you can’t imagine the headache) that took 4 spinal punctures to correct. The experience worked out for me in that I quit looking for a medical intervention and started PT, Stretching and weight loss with a vengence. THAT worked.
IF your doc is willing to do the paperwork, the appeals usually go through, but most Pain Docs don’t bother oppting instead to offer a cash price to those who they think can afford it. These docs who are in violation of their insurance contracts generally won’t be approved through the appeals process. essentially they have shown their true color$$. You have more success with approval with another doc.
This is a risky treatment, but far better to try this then just relegate myself to opiates. Sorry to hear that you went through paralisis, must have been scary.
The treatment with me anyway is consistantly reducing pain 75% over the last two years (3 treatments) the follow-ups are usually much shorter as they just have to burn the newly grown nerves, versus the first treatment. Treatment lasts 6 months on the money. He would have dumped me long ago if it was about the money, a rare caring doctor willing to work on my after hours and charge only $500 for a hour treatment, 8 needles, as he also does the transistional L6 area. We had already worked out the contigency plan of doing it for $500 at the last visit, I guess he knew it was a slim chance that they would approve.
I have complete trust in this doctor, he is one of the best in the area, I will pay cash before trying this with another specialist. If they have to split the treatment I will do the right side first as that has more pain, (fecal filled side😂)
With constant pain of the SIJ standing or sitting, I doubt that PT route would have sucess for my “normal” SIJ.
BTW my Rheumy is calling the radiologist to re-evaluate the MRI, I doubt he will take the time, but it is worth a shot.
My Pain doctor will do the 1 hour procedure for $500, very generous of him! 1 doctor one assistant operating theater for a hour, especially this procedure that has to be so exact…
He also has started a home for stray pets, so I guess I am one of his charges…
Got the denial letter from Blue Shield, they are saying the procedure is not covered in the agreement as a necessary expense.
Oh best of luck Jon.
I love the ‘home for stray pets’ angle.
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Every time I go in, he tries to give me a dog…
BTW here is my latest design for a cat dish to keep the ants out! Yes, I have a new adopted cat.
https://s26.postimg.org/aalrwybih/cat_dish.jpg
You fill the “moat” with water, making ants swim across.
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That’s gorgeous and innovative. If your cat is anything like mine though, it will also spend time patting the moat - my cat is obsessed by little amounts of water!