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Our Glorious Wealth Insurance companies

I've been with insurance provider 'X' for a few years now. They've recently decided to pad their pockets, one denial at a time. Doc says I need a new MRI thanks to a fall down the stairs. X says I can't have one because I just got one December 23 and they allow no more than 1 MRI in a 60 day period. I can't even request an MRI with any hope of approval for another 21 days.
Getting my first MRI was an act of congress. 3 denials before I threatened legal action and got approval. Not like they paid anyway, just had to have pre-authorization for it to count toward my deductible. I'm worried that we'll run into similar trouble getting pre-auth for surgery. I'm also worried that my doctors' patience is growing thin. His staff said he's seriously considering not accepting patients with insurance X anymore because of the problems they're giving him with me. With insurance x, your best bet is to not need a doctor for anything at any time. Has anyone here had similar trouble with their insurance? Or do you have a success story pertaining to a wonderfully supportive company?

Let's not bash any companies in this thread, but if you're happy with your insurer, please let us all know who they are.
:-)
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Comments

  • This is a bad time to need health coverage. The ACA (Obamacare) has caused so much confusion with doctors and insurance companies. I've been blessed that my WC company has never balked on care that my docs want me to undergo. Keep good notes on everything and if things get too bad, you may want to consult an attorney.
    Several Epidurals, L4-S1 360 ALIF, Numerous Facet Joint Injections, RFA x2
  • dilaurodilauro ConnecticutPosts: 10,059
    Many times its the fault of the doctors. It has always been the doctors responsibility to provide the rationale to the Insurance companies when it comes to Diagnostic Tests (MRI, CT-Scan, EMG, etc)

    Now in today's environment with so much being said about medical insurance, it is harder for the doctors to do that.

    But, I still believe that the doctors really want you to have one of those diagnostic tests, they will fight for you. Now, if they dont want or believe you need one of those tests, they need to tell upfront, so you know where you stand.

    Ron DiLauro Veritas-Health Forums Manager
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • So I paid for the mri. My ortho (barely) interpreted it, and told me to find another doctor. I strongly believe it is in part due to so much fighting with the insurance company. So here we are, back in square one, with my excruciating pain and no doctor. At least I have my scans.

    Insurance companies have made healthcare a jungle of red tape that you can't get through without a million dollar machete. Not to mention doctors being literally scared to treat their patients due to so many people claiming malpractice and negligence.
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