5 minutes ago, Eagle1ne said:

Or maybe no one outside of the blog takes him seriously.

I'm not a fan of character assassination of folks in their absence.  Not cool.

1 minute ago, Iggles_Phan said:

I'm not a fan of character assassination of folks in their absence.  Not cool.

I wasn't trying to "assassinate character". Mostly joking. 

Just now, HazletonEagle said:

I dont know what kind of MRI youre getting but a common rule with insurance companies for orthopedics is that you fail 6 weeks of formal physical therapy first. 

If you are looking for a musculoskeletal MRI, maybe that rule applies to you.

There are also some key words the insurance companies may look for in your file. Hopefully your doctor knows those buzzwords to hit in order to get things covered. 

 

Lastly, you likely still have the option of paying out of pocket. That is difficult for many patients, but depending on your pain level, or level of dysfunction or disability it may be money well spent.

 

For many conditions an ultrasound may be an excellent alternative to MRI, and is significantly cheaper if you need to go the out of pocket route.

Mine is a brain MRI. I’ve had the physical therapy thing before with a back issue I had, they wanted me to do physical therapy first, but I don’t know what they could want me to do before approving a brain MRI. All I was told was "they need more documented than what is had.”

Definitely not paying out of pocket, had a bunch of bills stack up recently. I’m going to make another office visit and make up a bunch of symptoms to make it sound life or death to see if they approve it then. Only thing I can think of at this point. Make the insurance company think this dudes gonna drop dead, gotta approve it or we could be sued if he dies.

3 minutes ago, Iggles_Phan said:

I'm not a fan of character assassination of folks in their absence.  Not cool.

Ok dad 

Talking about suspended posters is a pretty lame move. If you’re going to talk ish, do it to someone who can at least respond sheesh.

3 minutes ago, Eagle1ne said:

I wasn't trying to "assassinate character". Mostly joking. 

Not directed at you, specifically, but just the general direction the conversation was going.

10 minutes ago, Sack that QB said:

Mine is a brain MRI. I’ve had the physical therapy thing before with a back issue I had, they wanted me to do physical therapy first, but I don’t know what they could want me to do before approving a brain MRI. All I was told was "they need more documented than what is had.”

Definitely not paying out of pocket, had a bunch of bills stack up recently. I’m going to make another office visit and make up a bunch of symptoms to make it sound life or death to see if they approve it then. Only thing I can think of at this point. Make the insurance company think this dudes gonna drop dead, gotta approve it or we could be sued if he dies.

Yeah I dont know the ins and outs of getting brain MRIs approved. I just see the game from the ortho side of things. Crazy that insurance companies get to tell doctors how to practice. The doctor in the office, with the patient right in front of them doesnt get to decide the best course of action. Some guy in an office building who doesnt take time to read the medical notes and never saw the patient will decide instead.

Just saw a similar situation with my wife's grandmother. She has a brain tumor. Its been benign for years. But she gets herself all worked up with occasional bouts of vertigo. Any time she doesnt feel good, she gets concerned something is changing with her tumor. She recently had a bad stretch and really wanted her head checked out again and she couldnt get an MRI because I guess she already had one in the last calendar year.

I think she eventually ended up in the ED and one of her daughters was persistent about having imaging done. 

 

From what you said "need more documented" It sounds like your doctor is not hitting on those buzz words they want to see when they look at your chart. Is this a primary care doctor, or are you seeing a specialist? If its not a specialist, maybe youd have better luck with a specialist. Im sure theyre more familiar with the game. You may also ask if there is anyone in the office who is willing to do a peer to peer with the insurance company to state your case for you verbally. A lot of times stuff is in the notes and the insurance company just does not read well. Someone may be able to quickly be able to verbally explain your case and why an MRI is necessary. Its called a peer to peer and is very common. Many doctors dont like to bother with taking the time to talk to a-hole insurance people but often times they may have a PA or nurse on staff who does them in that case.

Falcons second shanked punt. Not a good game for them

2 minutes ago, HazletonEagle said:

Yeah I dont know the ins and outs of getting brain MRIs approved. I just see the game from the ortho side of things. Crazy that insurance companies get to tell doctors how to practice. The doctor in the office, with the patient right in front of them doesnt get to decide the best course of action. Some guy in an office building who doesnt take time to read the medical notes and never saw the patient will decide instead.

Just saw a similar situation with my wife's grandmother. She has a brain tumor. Its been benign for years. But she gets herself all worked up with occasional bouts of vertigo. Any time she doesnt feel good, she gets concerned something is changing with her tumor. She recently had a bad stretch and really wanted her head checked out again and she couldnt get an MRI because I guess she already had one in the last calendar year.

I think she eventually ended up in the ED and one of her daughters was persistent about having imaging done. 

It's stories like this that drive me mad. Meanwhile, there's Medicare fraud happening left and right (some cases have been brought justice with Feds getting involved). 

You do the right things in life and get the ish end of the stick while some "entrepreneur" rapes the system, but hey, Capitalism. end rant. 

Just now, bitbased said:

Falcons second shanked punt. Not a good game for them

Ran on 3rd and 4. Nutless.

1 minute ago, bitbased said:

Falcons second shanked punt. Not a good game for them

No one ever shanks against us.

1 minute ago, Saltpeter said:

Ran on 3rd and 4. Nutless.

With what personnel on the field? Sometimes it works.  

That was embarrassing

8 minutes ago, HazletonEagle said:

Yeah I dont know the ins and outs of getting brain MRIs approved. I just see the game from the ortho side of things. Crazy that insurance companies get to tell doctors how to practice. The doctor in the office, with the patient right in front of them doesnt get to decide the best course of action. Some guy in an office building who doesnt take time to read the medical notes and never saw the patient will decide instead.

Just saw a similar situation with my wife's grandmother. She has a brain tumor. Its been benign for years. But she gets herself all worked up with occasional bouts of vertigo. Any time she doesnt feel good, she gets concerned something is changing with her tumor. She recently had a bad stretch and really wanted her head checked out again and she couldnt get an MRI because I guess she already had one in the last calendar year.

I think she eventually ended up in the ED and one of her daughters was persistent about having imaging done. 

 

From what you said "need more documented" It sounds like your doctor is not hitting on those buzz words they want to see when they look at your chart. Is this a primary care doctor, or are you seeing a specialist? If its not a specialist, maybe youd have better luck with a specialist. Im sure theyre more familiar with the game. You may also ask if there is anyone in the office who is willing to do a peer to peer with the insurance company to state your case for you verbally. A lot of times stuff is in the notes and the insurance company just does not read well. Someone may be able to quickly be able to verbally explain your case and why an MRI is necessary. Its called a peer to peer and is very common. Many doctors dont like to bother with taking the time to talk to a-hole insurance people but often times they may have a PA or nurse on staff who does them in that case.

Yeah, the peer to peer was how I thought I was gonna be able to get it approved, but my doctor can't do it, he's making hospital rounds and he's unavailable over the next week and they have a grace period where if you don't get it done during that they can't do it. I'm either going to see if another doctor at the office can, and if they demand I visit with them first before doing such a task, I'll do that and see. But by then the grace period will be up, so they'll have to resubmit the MRI order again I guess.

1 minute ago, Eagle1ne said:

It's stories like this that drive me mad. Meanwhile, there's Medicare fraud happening left and right (some cases have been brought justice with Feds getting involved). 

You do the right things in life and get the ish end of the stick while some "entrepreneur" rapes the system, but hey, Capitalism. end rant. 

Yeah dumb rant…

the docs arent covering costs so has no incentive to use resources appropriately. Its bad yes but having govt do it is even worse. 

As much as it sucks, resources arent limitless and patients are terrible and unqualified tondetermine best course of action. You can still get whatever you want but you actually have tonpay for it if it doesnt make much sense

Laviska Shenault with the TD. Only his 7th career TD

Karens posting tonight 

Just now, Sack that QB said:

Yeah, the peer to peer was how I thought I was gonna be able to get it approved, but my doctor can't do it, he's making hospital rounds and he's unavailable over the next week and they have a grace period where if you don't get it done during that they can't do it. I'm either going to see if another doctor at the office can, and if they demand I visit with them first before doing such a task, I'll do that and see. But by then the grace period will be up, so they'll have to resubmit the MRI order again I guess.

Yeah. It may be understandable if your doctor cant do it, but if you are under a time crunch they need to be understanding of that and should have someone in their office who can. You are just as important as any of those other patients they are rounding on. Theres gotta be a nurse, or nurse practitioner, or PA who can do it. 

2 minutes ago, Eagle1ne said:

With what personnel on the field? Sometimes it works.  

Can't remember. Looked like 12 in shotgun.

Regardless, way too passive. They deserved to give up that TD.

35 minutes ago, EaglePhan1986 said:

It’s beyond a scam. I had to get a procedure done a few years back and it took me two years to pay off the medical bills. My insurance covered next to nothing. 

Your gender reassignment was elective, sorry

6 minutes ago, Eagle1ne said:

It's stories like this that drive me mad. Meanwhile, there's Medicare fraud happening left and right (some cases have been brought justice with Feds getting involved). 

You do the right things in life and get the ish end of the stick while some "entrepreneur" rapes the system, but hey, Capitalism. end rant. 

Capitalism works, hpenis is from a 3rd world country, he lived in a shoebox during his teenage yrs, he sold sniffs

Mariota finally picked off. He looks so bad.

I have no idea what these refs are watching.

1 minute ago, RLC said:

I have no idea what these refs are watching.

The clock. tick tick tick. 

52 minutes ago, MillerTime said:

Last week for 2 weeks. And DUM was not happy about it

Posted this a couple of pages back but still applicable. Almost convinced DUM and 4for4 are the same person.  He was crying about 4for4 every chance he got