10/8/2009 - Discography cancelled

The pain clinic in the hospital usually calls the day before any procedures and gives me the usual "don't eat or drink for 8 hours, etc...". When I was driving home from work yesterday I asked my wife if they called the house because I didn't get a call from them and thought that was odd. So, I thought we would go to the hospital at 8:45, the time I as supposed to be there. Before I woke up my wife called the clinic and they said the procedure was canceled. For some reason, even though I had the referral from our IPA, the hospital called the insurance company to make sure the procedure was covered. Well, as it turns out, it's not. Dr. Elborno's main nurse, Lynn, said she's been on the phone with the IPA (Hinsdale Physician Healthcare or "HPH") and that it's with the insurance company for review.

Now, had the hospital not called and I had the procedure, who would have been responsible to payment? I would venture to say that the insurance company would have denied the claim and said I was responsible. Now, I have a referral from my primary care physician that is stamped "HPH Approved" so who dropped the ball? The primary care? The IPA (HPH)?

At any rate, the procedure wasn't done and I'm waiting for insurance approval. As a result the appointment with the neural surgeon has been canceled as well, no reason to go to him without the discography details.

I really want this procedure done to identify *which* disc is actually causing the pain. The MRI's show C5-C6 to be in the worst shape but the pain is much higher than that, more like C2/C3/C4. Dr. Elborno keeps asking where the pain is because where I point to isn't what shows up in the MRI. What I DON'T want to happen is have C5-C6 fused when that's not the source of the pain. Of course, I'm guessing the insurance company would pay for C5-C6 to be fused then go back and have another set fused right? And if they fuse the one that isn't causing the pain what then? Are they going to pay for the additional time off work to have the CORRECT one fused since they don't appear to want to pay for the discography? I doubt it. Sort of like them not paying for stop smoking options but are willing to pay for cancer treatment...

More to come later.