A Few Things

There are a few things going on right now. First, the Mid-Atlantic area is experiencing a crippling series of snowstorms, so I have been stuck inside even more than usual. The new office is taking shape and I do really appreciate how I can physically separate phases of the day by just changing my scenery. It makes my world seem a tiny bit bigger.

Second, my insurance company provided an initial assessment and denied coverage for the ACI. This understandably freaked me out, as my research indicates I am a perfect candidate for it (BMI under 35, far too young for a knee replacement, damage contained to a limited area, failure of previous methods). I called Dr. Trice's office and spoke with his personal admin, Denise. She has been very kind and I am so grateful that she always seems to have time to answer questions. She said that the initial denial is not uncommon, but once the treating physician has a "peer-to-peer" review with the doctor making the insurance assessment, that it is usually approved. She said they had attempted to do that review, but were only able to leave a message. The crazy weather might be causing problems where the insurance doctor is located too.

It's funny to me that the reason the ACI was denied is that it is an unproven procedure. That makes no sense as it has been performed widely for years, has had multiple extensive studies (including a big one published last year), and it is routinely covered by insurance companies. I guess for something so expensive the insurance company must try denying it first to get the full picture of whether you really need it. Being a patient is awfully hard sometimes. Insurance makes me feel like I am following breadcrumbs in a forest and am always on the verge of getting lost and abandoned. And I have really good insurance!

The third thing going on is that I have another appointment with Dr. Trice on Monday. I believe we will be discussing the osteotomy and it will be a chance to ask questions about the ACI. Wish me luck!