Thursday, June 30, 2011

More Joys of Insurance

This morning, I was supposed to have my next round of tests from my episode from last Friday.  I had my referral from the doctor, and I had an 8:30 appointment at the radiologists to get the MRIs done on my brain and on my neck.  Unfortunately, my insurance company had other plans.

I received a phone call from the radiology office yesterday afternoon informing me that the referral, which needed to be approved, had been denied.  I called the insurance company to see why they were not allowing me to have the tests my doctor requested.  I was told that my medical profile did not fit for authorizing the tests.

Another thing that the insurance representative told me is that one of the reasons that the approval had been denied is that the tests were usually given to somebody who had already had a stroke to see the extent of the damage rather that to somebody to see if they were at risk of having a stroke.  This made no sense to me, as I would think they would rather prevent a stroke than treat one.

I finally was able to speak to the person who handles the referrals out of my doctor's office.  She told me that the reason for the denial was that I had not had a neurological consultation.  The doctor would have to review the documents regarding the denial and decide whether or not to refer me to a neurologist.   I am still waiting to see what will happen with that.

On a positive note, one of the things we were dreading trying to accomplish while my son has been home was getting him a dental exam for school.  The last time we tried he was very uncooperative, and we were unable to get a full exam.  This time he was able to get the exam, cleaning, and flouride treatment.  We still didn't get x-rays, but he did a great job.

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  1. Willy's recent experience with insurance - wife in hospital 21 days out of 60 recently. Just saw one of the final bills.-- Total so far is about $75,000 just for hospital and operation. Does not include Drs etc. Insurance writes it down to about $50,000 - Thank goodness for insurance.

    10-4 Willy

  2. don't get me wrong, I would rather have it than not have it, but to not be able to get a test because my doctor is a GP and not a neurologists is frustrating



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