Results 1 to 6 of 6

Hybrid View

  1. #1
    Join Date
    Dec 2007
    Location
    Ohio
    Posts
    2,006

    Default Re: Health Insurer Not Permitting Test

    Have YOU contacted the insurance company? I would get on their website and start firing off emails to managers and the like.

    I can see a MRI having to go thru channels, but not a CT scan. This is whats wrong with health care!

    If you contacting the Ins co doesn't work then...
    My best advice is the next time you have pain...go directly to the ER. Tell them who your primary care physician is. They will likely order an ultrasound then then eventually a CT scan. Its not the most moral or correct way to do this, but it is an option.

    Hope you feel better soon.

  2. #2
    Join Date
    Mar 2006
    Location
    I live here. Actually in a little area called the Knob. In Ohio
    Posts
    292

    Default Re: Health Insurer Not Permitting Test

    Thank you gigirle.

  3. #3
    Join Date
    Oct 2006
    Location
    supratentorial region
    Posts
    818

    Default Re: Health Insurer Not Permitting Test

    I agree with gigirle on both counts.

    Sometimes, if you (the customer paying the insurance premiums) calls the insurance company asking why the CT wasn't authorized, you may get a faster answer. When you reach a customer service rep., immediately ask for a supervisor and get first and last name. Get the dates and times the Doc's office tried to contact your insurance company. Do not be surprised if they tell you they never received communication from your Doctor's office (which will not be entered in their computer because they left them on hold and disconnected). Also....do not be surprised if your answer is: "We're not saying you shouldn't have the test, we're just telling you we're not paying for it".

    As gigirle also stated, sometimes you have no other choice but to resort using the ER. Problem is, and we're starting to see this more often, if the ER Docs don't think your situation is truly emergent, they will send you home with orders to call your PCP to get the Rx/referral for the CT.

    Best of luck getting this settled.

  4. #4
    Join Date
    Mar 2006
    Location
    I live here. Actually in a little area called the Knob. In Ohio
    Posts
    292

    Default Re: Health Insurer Not Permitting Test

    Update, I got on the website of the Health Insurance site and wrote about my doctor having a difficult time getting this test for me approved last night and at 11 a.m. this morning I got a call with the approval number.

    I also went to my supervisor at work and she took that matter to the lady that does the company insurance. I don't know what prompted that insurance company to act but I thought I would be fighting for the test for months.

    Thanks folks!

  5. #5
    Join Date
    Oct 2006
    Location
    supratentorial region
    Posts
    818

    Default Re: Health Insurer Not Permitting Test

    Quote Quoting BlueCrystal
    View Post
    Update, I got on the website of the Health Insurance site and wrote about my doctor having a difficult time getting this test for me approved last night and at 11 a.m. this morning I got a call with the approval number.

    I also went to my supervisor at work and she took that matter to the lady that does the company insurance. I don't know what prompted that insurance company to act but I thought I would be fighting for the test for months.

    Thanks folks!
    Fear of losing the contract with your company prompted them to act. As I said above, sometimes the patient/customer is able to get faster action than the Physician (people the insurance company have to pay).

    Glad you got it settled and good luck!

    1. Sponsored Links
       

Similar Threads

  1. Auto Insurance: Auto Insurer vs Body Shop vs Me
    By mdoz2006 in forum Insurance Law
    Replies: 1
    Last Post: 07-13-2011, 06:38 PM
  2. Auto Insurance: Insurer's Duty to Investigate
    By MouthingOff in forum Insurance Law
    Replies: 1
    Last Post: 03-21-2010, 11:25 AM
  3. Quiet Enjoyment: Landlord Permitting Homeless People to Stay On Premises
    By loglamb in forum Landlord-Tenant Law
    Replies: 1
    Last Post: 10-14-2009, 01:41 PM
  4. Subleases: Landlord is Not Permitting a Sublease
    By optimist27 in forum Landlord-Tenant Law
    Replies: 3
    Last Post: 11-01-2007, 03:26 PM
  5. Service Providers: Dispute With Movers - Demands payment in full before permitting claim
    By jage in forum Consumer Law
    Replies: 4
    Last Post: 01-19-2007, 11:10 AM
 
 
Sponsored Links

Legal Help, Information and Resources