Just so tired of almost every time a doctor submits stuff to insurance, we have to be the ones to make multiple phone calls to both the doctor’s office and insurance to iron everything out, figure out what the issue is (it’s always a different issue), and basically be the go-between for the office and insurance. What am I paying $500+/month for?! It’s like paying for the privilege of having an exhausting part-time job.
And yes, I understand that insurance wants to weasel out of paying anything, but this isn’t even shadiness, just straight up incompetence and lack of communication/following procedures. The amount of emotional energy we have to spend untangling this stuff leaves us drained.
I tore an achilles tendon last year. Doc wanted me in physical therapy, but PT wouldn’t take me because they needed an MRI showing the position and size of the tear.
PT was very clear. Tendons don’t show up on xrays.
Doctor was very clear. Tendons don’t show up on xrays.
Podiatrist was very clear. Tendons don’t show up on xrays.
Aetna: “You didn’t do an xray first, MRI denied.”
They try to spend less so aggressively that they end up actually spending more
Fought them for a month, meanwhile I’m in pain, limping with a busted tendon.
Finally we just gave in and did the xray, which - surprise! - showed nothing! Then they approved the MRI.
I hope you don’t have any long term consequences of that
Once I got into PT things seemed to go well, it was just a month of suck getting there.
Corporations are all about stepping over dollars to pick up pennies.