Insurance, and my GD doctor.
Posted: March 8 21, 4:16 pm
Rant time.
I've had a disc protrusion (L5/S1) for ages. Several years ago, I did PT, chiropractor, and then finally, spinal injections. The injections worked a few times and a couple of times didn't. So I wound up just taking two maximum doses of ibuprofen every day. That kept me upright, at least. I put off surgery due to several factors... my weight, work projects, kids, travel, etc.
Fast forward to now. My BP has been high. It's not responding to medication increases. My doctor was fretting about what to do next. I said, "Shouldn't I get off this daily ibuprofen?? Maybe it's time to finally do surgery." She acted kind of shocked, like I hadn't told her about the ibuprofen (I had). "YES. But let's get you a new MRI. It's been long enough, the neurosurgeon will want a new one."
But wait! Insurance just HAS to muscle into the picture and throw some elbows, right??? They denied my MRI. Said I have to do PT first. "First"... like I didn't do it like 3 or 4 years ago. They literally said on the phone today, "Yes, but have you done PT *this* year?" I answer "No, but my protrusion is CAL-CI-FIED. How in the name of little baby Jesus is PT going to fix the hardened bone spur pressing into my nerves?" The guy didn't have an answer. He just said, "Well, your doctor can file an appeal."
So I left my doctor another message stating they can file an appeal. My doctor's assistant responded: "There is no additional documentation that I can give. You do not have acute leg weakness or loss of bowel or bladder function. The requirement is PT for 4 weeks which can help at some times and then not work other times. Please proceed and if there is no improvement then we have grounds to appeal."
But I *DO* have acute leg weakness if I stop the fukking ibuprofen.
Insurance company only cares about the shareholders, and my doctor is apparently too busy to make a case for me to go straight to the MRI.
UGH. All these asshol3s can just go fvck all the way off.
I've had a disc protrusion (L5/S1) for ages. Several years ago, I did PT, chiropractor, and then finally, spinal injections. The injections worked a few times and a couple of times didn't. So I wound up just taking two maximum doses of ibuprofen every day. That kept me upright, at least. I put off surgery due to several factors... my weight, work projects, kids, travel, etc.
Fast forward to now. My BP has been high. It's not responding to medication increases. My doctor was fretting about what to do next. I said, "Shouldn't I get off this daily ibuprofen?? Maybe it's time to finally do surgery." She acted kind of shocked, like I hadn't told her about the ibuprofen (I had). "YES. But let's get you a new MRI. It's been long enough, the neurosurgeon will want a new one."
But wait! Insurance just HAS to muscle into the picture and throw some elbows, right??? They denied my MRI. Said I have to do PT first. "First"... like I didn't do it like 3 or 4 years ago. They literally said on the phone today, "Yes, but have you done PT *this* year?" I answer "No, but my protrusion is CAL-CI-FIED. How in the name of little baby Jesus is PT going to fix the hardened bone spur pressing into my nerves?" The guy didn't have an answer. He just said, "Well, your doctor can file an appeal."
So I left my doctor another message stating they can file an appeal. My doctor's assistant responded: "There is no additional documentation that I can give. You do not have acute leg weakness or loss of bowel or bladder function. The requirement is PT for 4 weeks which can help at some times and then not work other times. Please proceed and if there is no improvement then we have grounds to appeal."
But I *DO* have acute leg weakness if I stop the fukking ibuprofen.
Insurance company only cares about the shareholders, and my doctor is apparently too busy to make a case for me to go straight to the MRI.
UGH. All these asshol3s can just go fvck all the way off.