Asking for a friend.
I got tired of waiting for UMR to get around to approving my MRI so I went inpatient and stayed at the hospital for 2 days on their dime having an emergency MRI and surgery which could have been outpatient, had they been willing to work quickly.
The doctor does not do the refusal. He or she just signs it. Rejection was already built into the system.
IIRC there is a law that would require the doctor to use a certain minimum time to read and decide on such requests. Turned out they spend about 1/3 of a second per request, basically doing Ctrl-A and click “reject”.
People have had success emailing and asking for the name of the person that denyed your MRI so that you can either sue them for malpractice, or so you can sue them for practicing medicine without a license.
That’s kinda brilliant.
Unfortunately, corporate America loves deflection and simply ignoring or saying “It’s against our policy” is their go to answer.
I had severe migraines for weeks. Multiple a week. Doctor sent in a MRI request saying it was urgent I get it done. Insurance denies it saying its not medically necessary, tells me I need to start with X-rays first. Have you ever seen an X-ray of the head? Yeah, its just the skull. How the fuck is an X-ray gunna spot possible brain issues causing migraines? Never did get it approved for an MRI and the migraines just sorta stopped so 🤷♂️
Have you tried calling them and seeing why it’s not approved? Could be something simple.
It sure is a simple reason! It’s the insurance companies only make money by refusing to pay for your care.
Tore an achilles tendon.
Needed an MRI to determine the location and extent of the tear.Aetna: Denied. You didn’t do an xray first.
Doctor: Tendons don’t show up on xrays.
Physical Therapist: Tendons don’t show up on xrays.Aetna: You didn’t do an xray first.
In my experience, the Norwegian public health scheme has its share of drawbacks. But they have never been shy to order an MRI. I’ve lived here 5 years now and I’ve had 4… one of them just as a “might as well, it’s been a year since surgery” status update. And they all cost me about $25 each.
So, I don’t have a lot of background on this, but supposedly some doctors have engineered approvals by asking the insurance company from a signed statement by a doctor on the refusal letter.
It’s a legal thing to request so that the clinician can avoid malpractice suits, when asked by lawyers why they waited to conduct an MRI.
Then, when the insurance company searches their staff for a doctor that will sign such a statement, they may quickly realize none of the doctors on their staff want to risk being sued for malpractice by signing such idiocy.
Aetna gets around that by outsourcing the denials:
I had a labral tear in my right hip, and I needed an MRI with contrast to diagnose it. Aetna wouldn’t cover the MRI until I’d done 6 weeks of physical therapy. I ended up paying out of pocket for the physical therapy because it was an $80/session co-pay vs their self-pay rate of $70/session. Then once I’d finished therapy there was about 6 weeks of waiting until I could get in for the MRI, because Aetna wouldn’t let me get an MRI at the local hospital, I had to go to an outpatient imaging center and they were booked up. And when I got the results - what do you know, near complete detachment! Something that physical therapy would never help with. After that, I consulted with a surgeon (6 week wait), and his waitlist for surgery was 4 months. (Granted, I went to one of the top surgeons in my area - I was OK with waiting for that.) So it ended up being 10 months from noticing the hip pain in May 2023 to finally getting the surgery in March 2024, and a lot of that delay was because Aetna was being obstructive.
I suspect they want people to get fed up with the roadblocks and just give up on pursuing medical care.
In my case, Physical Therapy needed the MRI to confirm the nature and extent of the damage before they would even touch me. The 1 month delay caused by Aetna made everything worse.
How frustrating!!
I tore my rotator cuff and was told by my ins that i had to have an X-ray first. Of course the tear did not show up and the ins was still saying no need for any scan. My Dr’s office called them and was advocating for me, but the scan was denied until ins was told that I couldn’t even pull up my own pants! Suddenly the scan was allowed and the tear was found.
Maybe you need someone to inform them of a real-life consequence, like maybe it caused you to trip and hit your head?
Your ins? Internal doctors?
Insurance!
We did the xray, which showed nothing, then the MRI was approved.
They are still amazed not to have found a person whose tendons will show on an X-ray… yet
I know a guy…
He’ll need a live chicken, a lock of their hair, a sprig of night-blooming jasmine, an obsidian knife, and a moonless night.
They should suffer for all the pain their causing, not just yours.
I look forward to the day when we start publicly executing members of the ruling class and their henchmen.
I look forward to the day Jesus comes back and throws them all into hell.
Let’s not put our hope in a fairly tale fixing things for us
Then there’s no hope.
Well, not too hard, that would be too quick
Hard enough to knock them out, so you can write OATHBREAKER on their forehead.
I’m sorry for you mate, i can feel your pain (I’m twice operated on my L5S1 disc, and struggled years with the pain). Get a second opinion. in the meantime it’s important to make sure your muscles in that area keep up - Just stay active, don’t do nothing, because that will make it worse long time.
don’t pick up heavy weights (avoid anything above 5kg without that MRI). Make sure you lie good in bed; if the slipped disc is in the lumbar area, sleep either with legs up (just as you would in a chair, 90° angles in hip and knee), or sleep on the side with something between your knees so that your legs stay parallel. if it’s in the neck area, i heard that neck pillows work pretty well. If your bed is very soft, or the mattress is already heavily worn (or the “ladder-thingy” the mattress lies on) that’s not so good for the spine - so if a replacement bed is already on the horizon, maybe prioritize that.
Most slipped discs get better over time - the material that presses on the nerves gets reabsorbed, so you’ve got that going for you.
Huh, that’s all the stuff I’m doing. Doc said 5kg lift limit and just do whatever, as long as it doesn’t cause pain.
I really got to get back to work though, this monthly nut isn’t going to crack itself.
It maybe helpful to try and find out who the doctor is, where they are license, their speciality, and such. Might help you know how to build a legal case.
Otherwise something that leaves burns. Even light ones are tough.
Second opinions matter if you can swing them
Had a doc tell me I have a “mystery disease” four months before another at a larger specialty clinic gave me a tentative dx.
It sucks needing to travel for many reasons, but at least she has seen this issue before
Wow, that sucks. No, mine is a simple slipped disc or whatever, but insurance doesn’t want to follow my doc’s orders. Fucking United Healthcare.
Fuck you both. I hope both of you downvoters experience this exact back pain. You assholes. Fuck you and your grandmothers. This hurts like a motherfucker. Dick.
Eh I wouldn’t worry… Such numbers could simply be misunderstanding or misclick
Don’t stress about down votes. Each instance treats them differently and given the small amount of content compared to somewhere like reddit, even posts with fewer upvotes still get seen pretty well.
Posting complaining about down votes is a sure fire way to get down votes and for people to disengage.
I hope you get better soon. I had an MRI recently and they are pricey. I forgot to take off my wedding ring and there was a strange buzzy feeling on my finger. I thought they were stricter and more careful so the machine doesn’t get destroyed. Or the people!
Oh, I don’t care. I was just in a lot of pain last night and wanted to curse at someone and their grandmothers.
Glad to hear it was just a buzzing, I thought it could actually rip it from your finger
Yes, if there’s magnetic metals. It was my wedding ring, so it was precious metals. I presume the buzzing was a mild magnetic effect.
Or it could melt. Not exactly sure if it could realistically, though
Let’s-a-go!
It’s-a Luigi time!
