Guest guest Posted August 10, 2000 Report Share Posted August 10, 2000 Warriner from England.... wow, so encouraging to hear it is working out well. I am an avid and was once a very serious equestrian. My goal is to be able to chase after my daughter and ride with her in hunter paces and go on long trail rides with my whole family. I know of a group of riders in which many have had various forms of hip surgeries and are doing quite well. I don't know how so many of you have lived for a year or more with this pain. Mine started in Feb. and is now stage III-IV. The debilatation and the pain together is more than I can bare! Regarding insurance issues. Here is my story. I was certain my HMO would not pay for out of network surgery. But I was very lucky. My husband and I put together a packet of research papers (about 12) documenting the stats on resurfacing and the procedure itself. We wrote a letter that summarized my medical history and summarized the papers (only 1.5 pgs total) and made list of the references and gave this tidy little packet to my primary care physician. This made it very easy for her to write a very good letter to the insurance people. At the same time my physician office requested an authorization to see the out of network specialist. My doc sent her letter and the packet with our letter and I was given authorization to see the specialist at which time the director of the HMO said they would not approve a THR outside of network. After I saw the specialist and he sought approval for my surgery, they granted it. If you present them with a tight case upfront, they really can't say no. Perhaps I am just lucky and my procedure is also not considered experimental of investigational as I am not getting the conserve plus, only resurfacing of the femoral head if it is in bad shape, otherwise I will get only a graft. So, Good luck to all of you with your insurance fights. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 11, 2000 Report Share Posted August 11, 2000 Hello - Cate from Milwaukee here... I'm so encouraged by your success with the HMO. I'd love to get the list of the research articles you presented. Could you pass them on? Many thanks & best wishes! _______________________________________________________ Say Bye to Slow Internet! http://www.home.com/xinbox/signup.html Quote Link to comment Share on other sites More sharing options...
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