PVI insurance

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Posted by Lowell Rottrup on January 02, 2003 at 22:44:58:

Well folks, Regence BlueShield has turned me down on the third appeal to cover the upcoming PVI on 1-9. The next step is an independent review organization (IRO) which takes about 20 days and is basically the end of the road. I do have 180 days to make my last appeal. Before I go before the IRO I've got to get my act together. Here's what they said:"There is no FDA approved device for this treatment, and the long-term effects on health outcomes as a result of this technology are not established in the peer reviewed scientific literature. Therefore, the PVI is considered to be "investigational". Regence also quoted a CCF article that talked about design flaws that were responsible for nearly half of the recuurences following ultrasound ablation. So I need to find any AMA or other "Peer" writings that will sell Regence that the PVI is not "investigational". I've been talking to Peg Judson and crew but so far I don't see the end to the insurance tunnel. Looks like I'll have to do the "buy now pay later" plan. Anyway, this old boy has his "cold feet" moments, but we're still planning to go through with the PVI as scheduled.

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