Y'know, even when I suspect a person who has recently joined is a
spammer, I try to give them the benefit of the doubt. After all, even
a spammer could get AS. But sadly, it seems I'm seldom wrong in my
intuition.  So once again; Spam deleted. Author banned. Sorry about
that.

Spenser23as

I have blue cross insurance. High co pay level. Were I live in Tn
they want to cover everything at Vanderbilt but not many other places
were I live. I have had 8,000 so far this year out of pocket. This
new and great doctor I have is out of Summit hospital in the
Hermitage area. I went to the hospital for the first xrays and they
said i wasn't covered there. Go figure. I live in Crossville Tn and
had the same problems at home. Only one doctor I could see and he was
a jerk. No emergency number to call on my card. But it sounds like
the insurance takes all requests for any CT scan or MRI threw that
other company for approval. I had a CT done a few months ago at
Vanderbilt on an emergency basis. I received a letter like this a
week later saying they approved the scan. I little late and I had to
pay for more than half of it. Another 2,000 out of pocket. Were I go
for this MRI is an imagine center that takes my insurance close to
Summit hospital. I can only guess it get billed threw my doctor
because I had no out of pocket on the xrays done 2 weeks ago. Some
ask why I drive a truck with medical training and experience. Now you
know why. Insurance companies. Brian
--- In Spondyville@yahoogroups.com, christina price <cjjames3@...>
wrote:
>
> brian,
>     i'm not sure about what you should do as far as the insurance
goes.  i have had an mri done with insurance that didn't pay much on
it at all.  if you make payments to the hospital, and wait for it to
go to "their" collections, they cut the cost down incredibly.
someone at the hospital told me to do that.  how crazy is that?
sometimes you can get the cost down simply because you are paying
cash.  my sister does that one a lot too.  isn't insurance the pits
sometimes?  what a pain.  i hope that somebody else here can give you
better advice than me!!!  take care!
>   christi
>
> Brian Baker <bbaker904@...> wrote:
>           As some of you know I drive a truck over the road. I
arrived home
> today. I have an MRI scheduled for monday at 10am. In my mail was a
> letter from the insurance company saying they are denying the MRI.
What
> am I suppose to do now. I can file a grievance but that would take
> weeks. I can't afford to pay for the MRI in full. Now what do I do?
> Brian
>
>
>
>
>
>
> [Non-text portions of this message have been removed]
>

brian,
     i'm not sure about what you should do as far as the insurance goes.  i have
had an mri done with insurance that didn't pay much on it at all.  if you make
payments to the hospital, and wait for it to go to "their" collections, they cut
the cost down incredibly.  someone at the hospital told me to do that.  how
crazy is that?  sometimes you can get the cost down simply because you are
paying cash.  my sister does that one a lot too.  isn't insurance the pits
sometimes?  what a pain.  i hope that somebody else here can give you better
advice than me!!!  take care!
   christi

Brian Baker <bbaker904@...> wrote:
           As some of you know I drive a truck over the road. I arrived home
today. I have an MRI scheduled for monday at 10am. In my mail was a
letter from the insurance company saying they are denying the MRI. What
am I suppose to do now. I can file a grievance but that would take
weeks. I can't afford to pay for the MRI in full. Now what do I do?
Brian






[Non-text portions of this message have been removed]

I have a PPO. The company that refused the MRI is not my insurance
company but a place called MedSolutions. They review any CT or MRI
need by doctors. So I will call my doctor first thing monday. I think
the issue is diagnosis not given maybe. They wrote the requested
services/procedures are determined not be be medically necessary. So
someone did something wrong. You know how most places are. If you
don't give 24hr advance cancellation, they charge you. Brian
--- In Spondyville@yahoogroups.com, tchyder@... wrote:
>
> Brian, call your doc's office first thing Monday to inform them
that the MRI was denied by your insurance, and then ask him to fax a
letter of medical  necessity to your insurance company. Do you have
an HMO plan, or is it a PPO?
>
> I lmow quite a bit about insurance authorizations, so if you would
like more information about the process, please email me and I'll do
what I can to help point you in the right direction.
>
> Tyler
>
> [Non-text portions of this message have been removed]
>

Brian, sorry to hear that.  Okay, first thing, see if your Insurance
company has a 24-hour customer service hotline, and see if you can find
out a reason for the denial. If they don't have a hotline see if they
have a live advocate to speak with online.  Then on Monday morning at
9AM call the doctor who ordered the MRI and ask them to speak with the
insurance company on your behalf. Or you try calling the doctor
tomorrow, and see if the answering service will page him.

Unfortunately, I don't know what else you can do over the weekend. I'm
afraid you might have to call the MRI people and tell them you have to
reschedule. Tell them it's a personal emergency if you have to ...

Spenser23as

Brian, I forgot to leave my email addy. Here it is: tchyder@...

Tyler

[Non-text portions of this message have been removed]

Brian, call your doc's office first thing Monday to inform them that the MRI was
denied by your insurance, and then ask him to fax a letter of medical  necessity
to your insurance company. Do you have an HMO plan, or is it a PPO?

I lmow quite a bit about insurance authorizations, so if you would like more
information about the process, please email me and I'll do what I can to help
point you in the right direction.

Tyler

[Non-text portions of this message have been removed]

Can you call the company and ask why they are denying the coverage?
Perhaps have your doctor call on your behalf?  Perhaps with this
intervention, it could be rescheduled in a few days? It took 20 minutes
to do mine.

I would think that the charges are going to be awfully high - I had a
$40 copay and I have great insurance.  I don't know what my insurance
company was charged. I had back xrays done first and the dr reading
gave a narrative of my back but then he also recommended an MRI to get
more exact.  I'm assuming that you have had initial back xrays
already?
Vicki from Texas

--- In Spondyville@yahoogroups.com, "Brian Baker" <bbaker904@...> wrote:
>
>  As some of you know I drive a truck over the road. I arrived home
> today. I have an MRI scheduled for monday at 10am. In my mail was a
> letter from the insurance company saying they are denying the MRI.
What
> am I suppose to do now. I can file a grievance but that would take
> weeks. I can't afford to pay for the MRI in full. Now what do I do?
> Brian
>

As some of you know I drive a truck over the road. I arrived home
today. I have an MRI scheduled for monday at 10am. In my mail was a
letter from the insurance company saying they are denying the MRI. What
am I suppose to do now. I can file a grievance but that would take
weeks. I can't afford to pay for the MRI in full. Now what do I do?
Brian

Spenser,could you kindly remove my email adress from you mailer,thank you

spenser23as <no_reply@yahoogroups.com> wrote:          It's the weekend!! ...
Why not come and share a few laughs with your
fellow Spondyvilleans this weekend at our regularly scheduled Spondy
Cafe online chat sessions. Our first chat, begins at 10AM Eastern
time (7AM Pacific)AND, for all those West Coasters who find getting
up at 7AM on a Saturday for a chat to be a bit too daunting, our
second chat takes place beginning at 2PM PACIFIC time (That's 5PM
Eastern time.)

Our weekly Spondyville chats are open to all Spondyvilleans and their
loved ones. So, if you miss the early chat at 10AM Eastern, come join
the later chat at 5PM Eastern time.

To get to the Spondy Cafe: go to the Spondyville.com main page (Main
Street) and click on the "blue diamond" icon for "Spondy Cafe" ...
when prompted, enter your screen name, and then click on the button
and you will be taken to the chat room.

The residents of Spondyville have been meeting regularly online in
the Spondy Cafe since 1995.

To get to the Spondyville main page, use this link:
http://spondyville.com/Page14.html

Or you can use this link to go directly to the chat room sign-in:
http://spondyville.com/page47spondycafe.html

Again, the first chat will take place on Saturday morning at 10AM
EASTERN time. (9AM Central, 8AM Mountain, 7AM Pacific time.) AND
Chat#2 will begin at 5PM Eastern, 2PM Pacific time)

I hope to see YOU there!

Spenser23as







[Non-text portions of this message have been removed]

karlyn,
   oh i'm jealous!!!  i want to be in coeur d'alene so badly!!!  we have friends
that have moved up there so at least we can visit.  maybe on our next visit , we
can get together?   i don't think that it will be this year, unless we win the
lottery!  hehe!!  but we will try to get up there soon.  we like to go in
september because we drive and the weather is perfect for driving. not much rain
in washington and oregon.
     have fun with stiffy!!!  wish it were me!!  hehe!!
   christi

"karlyn.brown" <karlyn.brown@...> wrote:

Hi everyone!

Stiffy the Snowspondy has come to Sandpoint where he has been a
dignitary at both my and my husband's work places, he has gone out to
dinner with us, toured the sights and had several photo-ops. Stiffy
even attended the Spokane Spondylitis support group meeting!

He's now ready to experience another state :)

Karlyn B






[Non-text portions of this message have been removed]

Hi Everyone...What a surprise I had that day in Spokane when Stiffy was hanging
from the Spondylitis Support Group easel outside the meeting room!!! I got a BIG
chuckle.  I even thought Spencer had come to Spokane  to visit our Support
Group!!!  The greatest news was that I met in person Karlyn and her husband who
had driven two hours from Sandpoint, Idaho to attend the meeting.
Joan P
Spokane Support Group Leader
----- Original Message -----
   From: karlyn.brown
   To: Spondyville@yahoogroups.com
   Sent: Friday, May 30, 2008 7:02 PM
   Subject: [Spondyville] Stiffy



   Hi everyone!

   Stiffy the Snowspondy has come to Sandpoint where he has been a
   dignitary at both my and my husband's work places, he has gone out to
   dinner with us, toured the sights and had several photo-ops. Stiffy
   even attended the Spokane Spondylitis support group meeting!

   He's now ready to experience another state :)

   Karlyn B






------------------------------------------------------------------------------


   No virus found in this incoming message.
   Checked by AVG.
   Version: 7.5.524 / Virus Database: 269.24.4/1476 - Release Date: 5/31/2008
12:25 PM


[Non-text portions of this message have been removed]

Hi everyone!

Stiffy the Snowspondy has come to Sandpoint where he has been a
dignitary at both my and my husband's work places, he has gone out to
dinner with us, toured the sights and had several photo-ops. Stiffy
even attended the Spokane Spondylitis support group meeting!

He's now ready to experience another state :)

Karlyn B

faith,
     that is great news for the both of you!!  sounds like she is doing well.  as
soon as they get the one fixed, then they'll go and mess with the other one!! 
hehe!!  i'm glad for the both of you!!  take care!!
   christi

Faith Richardson <gammafaith@...> wrote:
           Good news,  mom can now put weight on her left leg, which means she
can now assist with transfers and ADL's. They could not do the surgery on her
right leg yet because of the skin graft and it will be at least 3 more weeks
before they can start planning the next surgery.  She is doing good in physical
therapy and hopefully will be home within a month.
My ankle is also better.  I no longer have to wear the boot. I am in a smaller
splint now and can wear my shoe with it.  It is still painful but doing much
better.
I am sorry it has been so long since my last post and hope all is well with
everyone.
Thanks for all the support.
Faith

[Non-text portions of this message have been removed]






[Non-text portions of this message have been removed]

Good news,  mom can now put weight on her left leg, which means she can now
assist with transfers and ADL's. They could not do the surgery on her right leg
yet because of the skin graft and it will be at least 3 more weeks before they
can start planning the next surgery.  She is doing good in physical therapy and
hopefully will be home within a month. 
My ankle is also better.  I no longer have to wear the boot. I am in a smaller
splint now and can wear my shoe with it.  It is still painful but doing much
better. 
I am sorry it has been so long since my last post and hope all is well with
everyone. 
Thanks for all the support.
Faith




[Non-text portions of this message have been removed]

It's the weekend!! ... Why not come and share a few laughs with your
fellow Spondyvilleans this weekend at our regularly scheduled Spondy
Cafe online chat sessions. Our first chat, begins at 10AM Eastern
time (7AM Pacific)AND, for all those West Coasters who find getting
up at 7AM on a Saturday for a chat to be a bit too daunting, our
second chat takes place beginning at 2PM PACIFIC time (That's 5PM
Eastern time.)

Our weekly Spondyville chats are open to all Spondyvilleans and their
loved ones. So, if you miss the early chat at 10AM Eastern, come join
the later chat at 5PM Eastern time.

To get to the Spondy Cafe: go to the Spondyville.com main page (Main
Street) and click on the "blue diamond" icon for "Spondy Cafe" ...
when prompted, enter your screen name, and then click on the button
and you will be taken to the chat room.

The residents of Spondyville have been meeting regularly online in
the Spondy Cafe since 1995.

To get to the Spondyville main page, use this link:
http://spondyville.com/Page14.html

Or you can use this link to go directly to the chat room sign-in:
http://spondyville.com/page47spondycafe.html

Again, the first chat will take place on Saturday morning at 10AM
EASTERN time. (9AM Central, 8AM Mountain, 7AM Pacific time.) AND
Chat#2 will begin at 5PM Eastern, 2PM Pacific time)

I hope to see YOU there!



Spenser23as

Don't look now, but a Snowspondy may be coming to help you celebrate
your birthday. :-)


Spenser23as

Wow, that's a popular date.  I have two very good friends whose birthdays are
June 13th.  Mine is June 10th so we all usually try to get together and
celebrate with a big homemade strawberry shortcake with fresh whipped cream (the
real stuff, not out of a can).

I think we're going to see that new M. Night Shyamalan movie, The Happening" for
our birthdays on Friday 13th since that's the day it comes out.

What are you doing for your birthday?

Lisa

[Non-text portions of this message have been removed]

In a message dated 5/30/2008 3:37:05 PM Eastern Standard Time,
tchyder@... writes:


But then again, if you'd like to send cards, books, money, funny  stories,
gaelic music and sunny skies, all will be shamelessly accepted. After  all, I'll
only be 55 once. ;-)

Ty






YOU ARE YOUNGER THAN ME???? LOL    but only a little  bit...;o)

betty



**************Get trade secrets for amazing burgers. Watch "Cooking with
Tyler Florence" on AOL Food.
(http://food.aol.com/tyler-florence?video=4&?NCID=aolfod00030000000002)


[Non-text portions of this message have been removed]

Hi Vicki

I hope you have read the other replies here because it is a big mistake to go
near a chiropractor when you have arthritis. Personally I have never been
willing to go near them but many people trust them.

If it is spondylitis that you have and not spondylosis then definitely stay away
from the chiropractor.

Maggie


From: vlmc1953
Sent: Friday, May 30, 2008 11:08 PM
To: Spondyville@yahoogroups.com
Subject: [Spondyville] new diagnosis


After suffering with back pain and pain shooting down my right leg and
having back xrays and an MRI, I have been diagnosed with cervical
sponydlosis most prominent at C4-5 with moderate disc space loss and
narrowing at C5-6, and lumbar spondylosis and anterolisthesis at L4-5.
The leg pain got worse, so I had an epidural steroid injection in my
back.. which made the leg pain go away for about 6 weeks, but the back
pain got worse.
Then my neck started hurting and the leg pains are worse so I went to a
doctor. X rays showed the atlas in my neck is not angled, there is no
curve to my neck, I have bone spurs in front, have phase III neck
degeneration and have clacification on my thryoid. Has anyone know of
any of these symtpoms? I've been on methotrexate for 4 months and was
just increased from 6 to 8 pills per week. The latest blood work shows
that my body is not responding to the metho. I think I need to try
something else - enebrel perhaps?
Spinal decompression has gotten very popular in Texas with many
chiropractors having a fancy machine that slowly stretches you. I have
read here that a chiropractor makes things worse for people with
spondylosis... Help! What should I do now? Get a second opinion?
Vicki from Texas





[Non-text portions of this message have been removed]

Are you kidding, Marvin? I can't even get Stiffy or Spiffy to come for a
visit...

Ty :-)

[Non-text portions of this message have been removed]

Ha, Ha, Rick. Definitely not a shameless card request; just trying to put some
levity in Sam's appt...

But then again, if you'd like to send cards, books, money, funny stories, gaelic
music and sunny skies, all will be shamelessly accepted. After all, I'll only be
55 once. ;-)

Ty

[Non-text portions of this message have been removed]

Friday, June 13th; that's correct, Michael.

Ty

[Non-text portions of this message have been removed]

Hi Vicki.  Spondylosis is not the same as Spondylitis, although they
are often confused for each other by both patients and sometimes even
doctors.  Spondylosis is a condition characterized by a narrowing of
the space between the vertebrae. It is usually a result of wear and
tear of the cartilage structures and supporting disc space that
normally separate the vertebrae. Spondylosis is commonly seen as a
feature of normal aging and is a typical finding in the spine
associated with osteoarthritis. Steroid injections into trigger
points can be of help for relieving stiffness and pain.  Spondylitis,
on the other hand, is a systemic arthritic condition, which usually
affects men and women for the first time between the ages of 20 and
34, and can affect the spine, neck, ankles, hips, and other joints,
sometimes fusing them. There is also a genetic marker which is often
associated with AS.

As for Chiropractors, people with Spondylitis should NOT let anyone
attempt to adjust or manipulate your spine if they are in the fusing
stage. With Spondylosis, I imagine the narrowing of the space between
the vertabrae would make any type of manipulation difficult, painful
and possibly dangerous. Of course, as with AS, if you have any type
of fusing at all in your spine or neck, avoid Chiroprators at all
costs.


Spenser23as

Hi Vicki, there are many here who have helped me. I'm pretty close
to you know but still going threw diagnosis. I worked in orthopedics
many years ago. I still multiple studies. I have seen a lot of
reports about fractures in the spine being caused by
chiropractitioners. They say that those with AS should not be seen by
them. I went the other week just to get an opinion from one. He
looked at my xrays and said my back looked no worse than anyone else
my age. OK didn't you see all the syndesmophytes in the lower
thoracic. That's the fusion spurs on the vertebra. He went back and
looked again and came back saying spondylisis. He wanted to try the
stretch out decompression and I said no and left. I liked
chiropractors at one time but not any more. But see what they say.
Just be advised of the fracture risk. Brian
--- In Spondyville@yahoogroups.com, "vlmc1953" <vmcfarl@...> wrote:
>
> After suffering with back pain and pain shooting down my right leg
and
> having back xrays and an MRI, I have been diagnosed with cervical
> sponydlosis most prominent at C4-5 with moderate disc space loss
and
> narrowing at C5-6, and lumbar spondylosis and anterolisthesis at L4-
5.
> The leg pain got worse, so I had an epidural steroid injection in
my
> back.. which made the leg pain go away for about 6 weeks, but the
back
> pain got worse.
> Then my neck started hurting and the leg pains are worse so I went
to a
> doctor.  X rays showed the atlas in my neck is not angled, there is
no
> curve to my neck, I have bone spurs in front, have phase III neck
> degeneration and have clacification on my thryoid.  Has anyone know
of
> any of these symtpoms?  I've been on methotrexate for 4 months and
was
> just increased from 6 to 8 pills per week.  The latest blood work
shows
> that my body is not responding to the metho.  I think I need to try
> something else - enebrel perhaps?
> Spinal decompression has gotten very popular in Texas with many
> chiropractors having a fancy machine that slowly stretches you.  I
have
> read here that a chiropractor makes things worse for people with
> spondylosis... Help! What should I do now? Get a second opinion?
> Vicki from Texas
>

Hi Vicki,

   I would DEFINITELY NOT recommend the spinal decompression or also promoted as
   VAX-D.  It became extremely popular in California over 10 years ago.

   The tiny, ity, bitty, bit the physical therapist did with me 4 years ago was
extremely painful and they didn't even use a machine.  Just a table and an old
fashion stretcher.  :)

   I've definitely found the chiro's to make things worse.  And being that you
have so many issues right now, I would stay far, far away.

   I would definitely try to get onto one of the biologics.  That's what I'm
trying to make happen this next month!  Are you seeing a Rheumatologist?  What
does your doctor say?

   Samantha

vlmc1953 <vmcfarl@...> wrote:
           After suffering with back pain and pain shooting down my right leg and
having back xrays and an MRI, I have been diagnosed with cervical
sponydlosis most prominent at C4-5 with moderate disc space loss and
narrowing at C5-6, and lumbar spondylosis and anterolisthesis at L4-5.
The leg pain got worse, so I had an epidural steroid injection in my
back.. which made the leg pain go away for about 6 weeks, but the back
pain got worse.
Then my neck started hurting and the leg pains are worse so I went to a
doctor. X rays showed the atlas in my neck is not angled, there is no
curve to my neck, I have bone spurs in front, have phase III neck
degeneration and have clacification on my thryoid. Has anyone know of
any of these symtpoms? I've been on methotrexate for 4 months and was
just increased from 6 to 8 pills per week. The latest blood work shows
that my body is not responding to the metho. I think I need to try
something else - enebrel perhaps?
Spinal decompression has gotten very popular in Texas with many
chiropractors having a fancy machine that slowly stretches you. I have
read here that a chiropractor makes things worse for people with
spondylosis... Help! What should I do now? Get a second opinion?
Vicki from Texas







[Non-text portions of this message have been removed]

After suffering with back pain and pain shooting down my right leg and
having back xrays and an MRI, I have been diagnosed with cervical
sponydlosis most prominent at C4-5 with moderate disc space loss and
narrowing at C5-6, and lumbar spondylosis and anterolisthesis at L4-5.
The leg pain got worse, so I had an epidural steroid injection in my
back.. which made the leg pain go away for about 6 weeks, but the back
pain got worse.
Then my neck started hurting and the leg pains are worse so I went to a
doctor.  X rays showed the atlas in my neck is not angled, there is no
curve to my neck, I have bone spurs in front, have phase III neck
degeneration and have clacification on my thryoid.  Has anyone know of
any of these symtpoms?  I've been on methotrexate for 4 months and was
just increased from 6 to 8 pills per week.  The latest blood work shows
that my body is not responding to the metho.  I think I need to try
something else - enebrel perhaps?
Spinal decompression has gotten very popular in Texas with many
chiropractors having a fancy machine that slowly stretches you.  I have
read here that a chiropractor makes things worse for people with
spondylosis... Help! What should I do now? Get a second opinion?
Vicki from Texas

She is just getting it in early so that we all have time to get her a present
and get it shipped out in time. lol Just kidding TY.
Marvin
   ----- Original Message -----
   From: spenser23as
   To: Spondyville@yahoogroups.com
   Sent: Thursday, May 29, 2008 9:12 PM
   Subject: [Spondyville] Re: Ty's Birthday


   Wait, Tyler's birthday isn't until Friday, June 13th ... Or did I mis-
   read her post?

   Spenser23as






------------------------------------------------------------------------------



   No virus found in this incoming message.
   Checked by AVG.
   Version: 8.0.100 / Virus Database: 269.24.3/1472 - Release Date: 5/29/2008
7:27 AM


[Non-text portions of this message have been removed]

Wait, Tyler's birthday isn't until Friday, June 13th ... Or did I mis-
read her post?


Spenser23as

Good to see you back, Mandy! shifting one's life from 'normal'
into 'coping with AS' mode, isn't always an easy transition, so a
little back sliding into depression is perfectly normal. Just try to
keep a positive attitude and don't lose your sense of humor.

Sounds like a great vacation you've got planned! Have fun! Starting
the Humira or other biologic drug early on will hopefully enable you
to avoid the long term damage some of us oldtimers have had to deal
with. I sure wish these anti-TNF drugs were around twenty years ago.

And please remember, if you're ever going through a deep depression
and need to talk to someone, (and I guess this is addressed, not only
to you, but to everyone in the group), please feel free to contact me
privately or, if not me, someone else you feel comfortable with in
the group. We're not psychologists, obviously, but we can listen to
you and empathize and perhaps offer some advice based on our own
experiences in dealing with this disease.  My point is, no one should
feel they have to go through this alone. Wherever you are, we've all
been there at some point, so we can understand what you're going
through, and, my feeling is, if my insight can help, it's yours for
the asking.)

Spenser23as