rachelmanija: (Make my day)
( Jun. 20th, 2005 10:09 am)
So...

My former doctor (Dr. G) prescribed a CT scan for my back. My insurance denied it. Twice. I appealed. Twice. Finally, after I had spent something like twenty hours trying to get it approved, they approved it, five months after it had originally been prescribed. Since there had been no improvement in my condition in those five months, I immediately had it done. Afterward, since I wanted a second opinion and also Dr. G was totally inaccessible, would not write the multiple letters and make the multiple phone calls that my insurance demanded, and lost my X-rays, I switched to Dr. C.

Now I've been sent an eight hundred dollar bill for the CT scan. I called the insurance and pointed out that they'd authorized it. Yes, they said, but only on the condition that it was done within a month of the original prescription. But I couldn't do it within a month of the original prescription because you refused to authorize it for five months. Yeah, well, they said, that was my responsibility to know about that and get a new prescription. Since I didn't know that, my only recourse now is to get Dr. A to write me a new prescription retroactively authorizing the CT scan that's already been done. This is likely to be difficult, since I am no longer his patient, I already know he lost at least part of my chart, and he was impossible to get hold of even when I was his patient.

Dealing with insurance has caused me to lose more work hours than the injury has.
rachelmanija: (Make my day)
( Jun. 20th, 2005 10:09 am)
So...

My former doctor (Dr. G) prescribed a CT scan for my back. My insurance denied it. Twice. I appealed. Twice. Finally, after I had spent something like twenty hours trying to get it approved, they approved it, five months after it had originally been prescribed. Since there had been no improvement in my condition in those five months, I immediately had it done. Afterward, since I wanted a second opinion and also Dr. G was totally inaccessible, would not write the multiple letters and make the multiple phone calls that my insurance demanded, and lost my X-rays, I switched to Dr. C.

Now I've been sent an eight hundred dollar bill for the CT scan. I called the insurance and pointed out that they'd authorized it. Yes, they said, but only on the condition that it was done within a month of the original prescription. But I couldn't do it within a month of the original prescription because you refused to authorize it for five months. Yeah, well, they said, that was my responsibility to know about that and get a new prescription. Since I didn't know that, my only recourse now is to get Dr. A to write me a new prescription retroactively authorizing the CT scan that's already been done. This is likely to be difficult, since I am no longer his patient, I already know he lost at least part of my chart, and he was impossible to get hold of even when I was his patient.

Dealing with insurance has caused me to lose more work hours than the injury has.
.

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