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Insurance nightmare

JennyfooJJennyfoo Posts: 81
edited 06/11/2012 - 8:36 AM in Upper Back Pain, Thoracic
I'm stuck in an insurance nightmare over getting a 2nd opinion on my back. I'm now on my 2nd kidney infection in a month, due to the nerve impingement causing bladder retention. All the neurosurgeons in my current network are networked together into one practice, so it's a conflict of interest for another to see me. So they're trying to go out of network. One other network already declined:they won't treat patients in my network, period. Now they're trying EDITED, which is good, because I'd already contacted them and was trying to get into the EDITED, was willing to completely change doctors and networks in order to do so. Ive already spoken to a new patient coordinator and my current neuro is supposed to fax over my MRI and chart notes- was told they'd do it last week, but it's still not been done. Hopefully it gets done today, like the receptionist told me she would, then the doctors at EDITED will look over my MRI and chart notes and decide if they'll see me or not. Since my primary care physician is putting in a request too, that should get me in. ~crossing fingers~

I can't keep getting kidney infections. I'm immunosupressed, on Humira for my autoimmune disease, and every time I get an infection, I have to forego taking my meds until I'm over the infection. My arthritis flares up when I don't get my Humira, whole-body inflammation does. I'm scared to death they're going to insist I stay off it now that I've had 2 kidney infections. I can't function without my Humira and I also develop iritis. Iritis is inflammation of the vascular layer of the eye- which causes blindness if not controlled, and I've already lost 5 points of visual acruity in one eye and 10 in the other from a 2 month bout of iritis over the summer. I know I have to go off the Humira for a month prior to and after surgery, but I need to be on it as long as possible. Apparently, when you go off it, your body will often develop an immunity to it and it won't work when I go back on it- if you've been off it too long.

Doctors name and contact details removed by forum Moderator (paulgla). We do not permit publishing specific doctor's or institution names and contact details.


  • it sounds like groundwork has been done for you to see a new dr. i just feel bad you have all these health problems and your important treatment is on hold. for your sake and the well being of your kids i hope the switch happens soon....pete
  • Thanks Pete. Oops, sorry to the mods too.

    The out of network dr. I'm hoping to be sent to is affiliated with one of the top 25 neuroscience centers in the US.

    Now get this: My current neurosurgeon's office called back. What they had to say about the kidney infection: Go see a urologist. WHAT! My kidney problem is being cauesd by the nerve compression in my back! I have no feeling in my abdomen, and ridiculopathy there, so I can't feel if something is off. I've managed to go 32 years without a single UTI, now I get 2 kidney infections within a month, after this back injury. What's a urologist going to do? It's the back problem that needs o be treated! I certainly hope they can get me in to the other Dr and SOON!
  • My brother experienced major UTIs and had reconstructive surgery of his equipment and mostly it's because he had back problems also after a 3 story fall shattered his lumber spine 25 years ago but he's otherwise doing well with everything now. Hopefully you won't require surgery but a Urologist referral may help you. I hope you get some relief and hope you can get healing for your many physical ailments. Wishing you healing thoughts. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • The Neuroscience center Dr. refused to see me. Another 2 practices have also refused to see me, due to being overbooked, not enough time dor the patienrs they have in-network. I gave no idea what to do next. i am so frustrated and depressed about this whole situation. In the past few days, weakness in ny leg has gotten worse- I need a walker in the house now, and I'm having no advance warning when I have to go to the bathroom- bladder or bowel: I have to rush to he bathroom. I guess I'll have to see if my current neuro will take me seriously now and see me. If not, it's back to the drawing board.
  • If you can't hold on to your bladder or bowels then you need to go to the ER ASAP. Since you are having these problems and you're feeling worse, it may be a sign of Cauda Equina Syndrome which is a medical emergency. Please let us know how you do. Take care
  • Well, I found out what's going on and why I was turned down. My incompetant Dr's staff did not send my new MRI from July '09, they sent my old one from July '08. So the new surgeon read that one, read the notes showing I'd had surgery, and ovbiously passed. AUGH! So, I called my personal care physician's office and had them fax the new MRI this afternoon. I am so glad that I called the patient coordinator at the Neuroscience institute back and asked her to look into why I was denied. She called back, telling me she'd consulted with another Dr. at the clinic and she had recommended I see a pain mgmt specialist, which I told her I already was seeing. Then she asked when my latest scan was, and was floored when I told her that it was just done in July. Thank goodness this girl had the presence of mind to look into it and ask me the right questions. Perhaps all is not lost and I'll get in to the Neuroscience Institute after all.
  • I've been having bladder incontinence basically since I saw my current neurosurgeon. I realize it's a serious matter, but he doesn't seem to. If I suffer permanent damage, it's on his head.
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