This is an extension of this thread I started, but a issue worthy of its own.   Since I haven't posted 10 times the forum won't let me post a link, but the thread is titled "About to be Diagnosed".

My wifes Neuro surgeon has made the request for the EDAMS surgery procedure as an option if the bypass proves unachievable due to blood vessel size.  Insurance has declined coverage based on the claim that the bypass is the proven medical first option, or standard means of surgical treatment and the EDAMS has not been proven.  they go on to quote medical literature stating that it is the consensus of opinion among experts that further studies, reserarch and clinical investigation are necessary to determine the safety and efficiency of the EDAM as compared with the standard means for treatment of the condition in question.
Hopefully some of you can help chime in with some information in regards to the medical fields postion on EDAM surgery in relation to insurance companies perspective. 

Brad

Hello,

My wife at the EDAMS procedure done at OHSU on October the 4th 2012.  Insurance didnt have any issue with it.  I will look at the paperwork and double check that it was recorded as a EDAMS procedure.  Crossing my fingers for you.  OHSU was fantastic!  DR. Dogan was the Neurosurgeon.  Send me a message if you need any more info. 

Well, that is all settled.  Without getting into a political conversation regarding it, the federally recognized tribe that I worked for at the time, and their self owned insurance company, finally paid out after I lawyered up and spent 20,000$ to fight their casino.  If you think you have rights on tribal land inside the U.S, you are mistaken. 

Health insurance is a contract between you and your insurance company. You buy a plan, and the company agrees to pay part of your medical costs when you get sick or hurt.



houstonnationalinsurance.com/