Why would bc/bs deny my mri?

Question

I had an accidnet 2 years ago and have had a strange knot in my back, my doctor suggested an xray, I had the xray and it was neg,,, My doctor is not suggesting an mri but the insurance company wanted me to go through physical therapy first,, it was too painful... and the insurance company is still denying my mri... my doctor suggests that I see an orthopedist,,,, do you think the insurance company will let me get the mri if the ortho recomends it??? why are they such a pain?

Answer 1

If you go to an Ortho Doc They are usually more likely to give you an MRI beofre your Primay Care Doctor would, BEucase thats there "specialty". They may want you to try PT first but if you tell them about the pain and spiecifally where its located they should be able to justify with BC/BS to get an MRI authorized for you. Good luck!

Answer 2

The golden rule for medical treatment is all possible options must be exhausted before they do mris and surgery. PT does hurt in the begining but it really really helps most times... The best thing for you to do is go to Ortho and explain to them what happened and see what they say. I did the same thing and had the same story as you and it took till my last option with an Ortho doc to get an mri. All I did was explain it all, get x rayed another time, then requested a mri through them.

Good luck to ya.

Answer 3

Responding to the last part of your question: "why are they such a pain?"

...Because Obama's not our president yet.

I'm so sorry you have to go though this, and I hope it turns out for the best. I pray that the day will come soon when we will all have the right to live healthy lives, and not have people make money off of our suffering.

Answer 4

Insurance companies always jerk you around.  I have a spine injury from a auto accident and it took the doctors several X-rays, MRI's and other tests over a period of a few years to figure it out.  I also had the fight with the insurance company to get things approved.  Partly because of their delay I ended up with permanent nerve damage.

Just go see the orthopedic doctor,, if your doctor is sending you to an ortho he must think there is something,,, orthopedic doctors are surgeons,, if he suggests a MRI they will approve it.

Here are a few links that may interest you.  

http://www.uclahealth.org/body.cfm?id=47...

http://spine_health.com