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  1. #1
    Join Date
    Nov 2017
    Posts
    4

    Default Pre-Auth Approved Spinal Fusion, Dd Says Injuries Are Compensable, Ic Won't Pay Tx

    Semi to semi accident at work in Texas.

    Pre-auth approved lumbar fusion surgery. Designated Doctor listed ruptured disc, radiculopathy and nerve damage as compensable The insurance company had a peer review done for the extent of injury and the Doctor said my claim is limited to a sprain. Now the insurance company is refusing to pay for the surgery that was deemed medically necessary by their pre-auth department, DWC ombudsman said she can't schedule a BRC because the Designated Doctors has already given his opinion, so there is no dispute. I am at a complete loss on all of this.

  2. #2
    Join Date
    Nov 2017
    Posts
    2

    Default Re: Pre-Auth Approved Spinal Fusion, Dd Says Injuries Are Compensable, Ic Won't Pay T

    lawyer up if I was you

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