Insurance company that denies prior approval on scans for cancer patients! This more than stirred me up it straight pissed me off
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Stirred UP
- Thread starter DocHoliday0831
- Start date
Or just dictate in general. Took 3 years to determine that the Mrs. has primary progressive MS all because the insurance company wouldn't allow a certain kind of scan. So 3 years of getting worse. 3 years of countless other tests and specialists. 3 years of not knowing. Even an un-needed surgery because they were treating symptoms instead of the problem.
All because some jackass that has never met the patient want's to "save unnecessary spending" by spending 15 times as much in the long run.
Now it's been a year+ fight to get her disability (which is still with an attorney and not through yet) which she is getting denied on because she doesn't have enough recent work history, because they screwed around for so long. So over 4 years of dragging out this whole process because they didn't want to pay for one test.
Not to mention that 98% of people are diagnosed with relapsing MS before it progresses, so she most likely would have had a better shot at it being controlled and slowed down. Now it's just full blown final stage and there are no relapses.
Medical insurance rules our healthcare system. I hate that it does. Your anger is justified. If an oncologist wants a scan, or a more expensive scan, they certainly have a clinical reason. Oncologists don't get paid by the scan.
Unresponsive supervisors. I've got one, and it annoys me to no end.
When HMO's first came on the scene they did a lot of good, but now I have to agree with everyone her. They make you rack up extra charges in the name of saving money. I have to see my participating provider, which is an office visit fee, just to get a referral to a specialist. Now wouldn't it be cheaper to just let me head straight to Dr. 2 rather than incur the cost of both?
When I stuck a screwdriver in my hand at a previous job, I went to the walk-in and they opened up a whole kit that had like 12 tools in it but only used 2. I asked them what was going to happen with the other metal surgical tools and scissors and they said they have to throw them away. I asked them who paid for the tools and they said my insurance, so I told them I would be taking them home. Boy did they think I was strange
Now I have a decent trauma kit in my EDC pack.
When I stuck a screwdriver in my hand at a previous job, I went to the walk-in and they opened up a whole kit that had like 12 tools in it but only used 2. I asked them what was going to happen with the other metal surgical tools and scissors and they said they have to throw them away. I asked them who paid for the tools and they said my insurance, so I told them I would be taking them home. Boy did they think I was strange
The whole healthcare experience these days is pathetic. Whether you are seeing the DR (joke) or one of their NP's or PA's none of them listen to what you are saying or give you enough thought to actually solve or prevent problems. They behave like they are in triage mode at a mass casualty and you are keeping them from more important things.
I blame the staff as much or more than the caregiver. I could go on and on but I wont. I will say those who don't have a modest amount of medical knowledge are taking their lives in their hands.
I blame the staff as much or more than the caregiver. I could go on and on but I wont. I will say those who don't have a modest amount of medical knowledge are taking their lives in their hands.
Sorry you guys are having some bad experiences. I have to say the speed of treatment and communication I had directly with my doc while I deal with that kidney stone was impressive to me. And he didn’t know I worked for the same hospital he did.
Dave in KY
Shave Newbie
Sounds like a story there Chad
I don't even know if I can talk about this one yet. I'm sending it in to the state. There could be an investigation
In my opinion...this is the fundamental issue with our current "sick-care." I will refrain from ranting at this point because I know you all have heard it before. But if healthcare would be willing to try to get to the root of a problem and not just treat symptoms...we would be a much healthier world!
I think that I am lucky in that i found a health care professional that is willing to talk to me for 45 minutes when I see her. I am sure she rolls her eyes every time she sees my name on her chart...but I am appreciative nonetheless. We disagree a good bit, but in the end both of us compromise and we agree on a plan of action. And today...I am much healthier for it. These types of medical professionals are very rare in my opinion!
Chris...this might be the wisest thing I have heard in quite some time! It is one of the reasons I have decided to take my own health into my own hands! While my conditions were not all that simple...researching them were. I really feel for people like Shawn and his wife where those types of conditions are more complicated generally than the normal person can research. I honestly applaud Shawn and his wife sticking to their course. Many others would have given up a long time ago!
Actually, we have a NP as our primary. She is awesome. She knows everyone in the family, takes the time to talk to you and find out what's going on both personally and medically. I couldn't ask for a better primary.
The problem was with the insurance company dictating what she could and couldn't do. She ordered a full set of all kinds of tests very early on because she didn't know what it was. Blood work and everything all came back normal. She sent her to specialists for each of the symptoms hoping they could confirm or rule out something. But again, MRI's are "too expensive" so she had the same blood work done probably 20 times. Even her spinal tap was clean. It wasn't until 3 years into the process that she was finally able to get an MRI ordered and found the lesions.
Overall, the physicians we saw were pretty decent. There was one oncologist that was an idiot, but for the most part it was good. It was just the insurance that flat out ******* with peoples health and well being when they have absolutely no clue what is going on.
Definitely glad you have good providers that are willing to talk to you. I see a nurse practitioner also...and love her! I have said it elsewhere...but she spends on average of 45 minutes a visit with me answering my questions. But even with her...there are limitations. It wasn't until I asked her to test my Vitamin D levels that we found out that I am Vitamin D deficient. But I definitely agree with you on the insurance side of things. When will they learn that money paid up front is likely to cost less later on. At least in the over simplified version of the world in my mind.
The built in obsolescence of technological products makes me sad.
Dave in KY
Shave Newbie
Been perusing the forum while waiting for USPS to take me off hold for nearly an hour and counting. Tracking recording says if package doesn't arrive by the 23rd call us.............Ummmm, today is the 23rd and it didn't come. Probably got put on wrong truck and don't want to show it on the tracking but I'd feel better seeing it take it's world tour rather than get NO update for 5 days on a package that sipped a week ago and was supposed to be 3 day delivery.......
Dave in KY
Shave Newbie
Over an hour on the phone and nice gentleman picks up and starts a case which just notifies my local Post Office to do a search and call me in 2-3 days to update me on it's whereabouts.........stall tactic. If they knew where it was, they'd have told me. At least the process is started. Hopefully shows up Monday............
GearNoir
“The Disney Princess’s Apprentice”
Yea, all the major mail carriers can be frustrating like that. I never pay for expedited shipping any more, only what’s standard for the type of package.
Sorry Dave.
Dave in KY
Shave Newbie
Thanks, I'm not worried about expedited shipping but tracking going dark for 5 days does bother me. Oh well, maybe I don't have a 6s anymore...........