Wednesday, May 16, 2012

Insurance is a Pain in His Butt

We have had a crazy year so far. Steve has been dealing with back pain for ever and this year it has become unbearable. He started the year with an MRI and a visit to his neurosurgeon. The surgeon suggested a new device used for a spinal fusion at one level, L4-L5. The device, the Aspen Device, was denied by the insurance company, but not the surgery itself. The surgeon sorta appealed the denial in a very basic manner. The insurance company then said the device was an approved device, but the he was not a candidate for fusion surgery, "Not medically necessary". That led us to work on an appeal of that decision which led Steve to have epidural blocks (the third time in 6 years). They didn't work this time either. He then went in for a second opinion. That neurosurgeon didn't like the Aspen device and felt Steve was a prime candidate for a traditional spinal fusion. Since he only had one level of diesease it could take away 85% of his pain. So, they sent the information in to the insurance company, that was two weeks ago. Here we sit Baptist hospital East going on night two inpatient. Over the weekend Steve pain level become so high that he couldn't get any relief. So on Monday morning his brother (Steve's primary physician) called his surgeon and explained what was happening and they decided to admit him for pain control. We still had no response from the insurance company, but they are paying for ALL of this hospital stay. He has been on morphine and steroids since Monday night. The steroids cause high blood sugars so he is also receiving insulin. Yesterday the ordered another MRI to see if things have gotten worse. Then last night he started getting pain in his right hip and down his leg. He thought maybe that the disk had bulged again. Once the NP came in today we still have nothing from the insurance company and the MRI shows he now has a bulging disk at L3-L4. That means he will also need another discectomy. So right now we are on day two of hospital stay waiting for the surgeon to come in...tonight or tomorrow. So I will be staying the night too! Praying that the insurance company finally does what we pay the for and approve the surgery so my husband can begin to live the normal life of a 44 year old man. PLEASE JOIN ME IN PRAYER.

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