And the verdict is in.....

Well after 5 weeks of waiting for the process of letter writing, proofreading, re-issuing another version, and than sending it off to Aetna... Yes, this morning, my spy V" once again called into the Aetna insurance contact Julie who is the nurse reviewer who actually had an answer. "V" was told that Ramone had been contacted in the specialist office of Dr. Ferkel and ....... the case was DENIED. WHAT? Due to someones outstanding reasoning at Aetna that "the case falls outside of the parameters of policy for experimental procedures where the results are unfounded". ugh! I was stunned, than tearful at the letdown, than in the midst of setting a pity party for one, and than just sullen..... (no susan, I didn't follow through on pity plans)

the WHAT? Is this just a standard business practices denial to make them file the appeal for the sake of time delay ... possible, which sometimes is to deny 8 times.. The WHY? most likely because no FDA approval for surgery procedure gives them the ability to deny and not have to justify.. NEXT? I don't know exactly, but they had mentioned prior that they would appeal, so I will assume that is what they-the dr's staff (when they find out) will begin to investigate into.

If this same procedure were prescribed for a knee with this same condition... it's FDA approved, no problem in just getting insurance to precertify as a simple procedural step and away the patient goes along in the process. But for an ankle - no dice in America.

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Today, I also experienced a reoccurance of the pain in upper spine that the 8 injections were to "block".... not a good sign, and a blow to my psychee!

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Tomorrow I will need to work on my attitude for the "thanksgiving" feast approaching, today I can't muster it.