How JustAnswer Works:
  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site. Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.
Ask wieyedoc Your Own Question
wieyedoc, Doctor (MD)
Category: Health
Satisfied Customers: 11417
Experience:  Internal medicine internship in New York City. Two decades+ of medical experience
Type Your Health Question Here...
wieyedoc is online now
A new question is answered every 9 seconds

Aetna has also denied my husband's claim for spinal

Customer Question

Aetna has also denied my husband's claim for spinal instrumentation using coflex-F(Paradigm Spinecode 22840 stating that this device is not covered because it considered experimental and investigational. The Aetna medical director who denied the appeal is a Board Certified in Obstetrics and figure. My husband was diagnosed with severe spinal stenosis; fusion was not an option due to the condition of his spine. Why do they not want to cover if this has been approved by FDA?
Submitted: 2 years ago.
Category: Health
Expert:  wieyedoc replied 2 years ago.

Hi. My name is***** and I am online and available to help you today. Thank you for your patience.

Question and answer is just one of the services I offer. I can also provide you with additional services, such as live telephone or skype consultation, at a small additional cost. Let me know if you are interested.

They do not want to cover it because it is expensive and will cut into the CEO's bonus.......simple issue with profit.

You might want to hire an attorney who is experienced in these types of insurance denials to assist you but, I must warn you, it will be a long, expensive and uphill battle.

Does this make sense to you?

Don't forget to mash the positive feedback button for me...the one labeled "excellent" is the most fun to push by far ;)

It's safe for you to press the positive feedback button now if you so desire. And, never fear, even after you press that button I don't go up in a puff of smoke -- I'll still be right here to continue helping you, but, as I do work for tips, I want to make sure you are happy before rating me.

Dr. Rick MD FACS