Multiple Sclerosis (MS) Support Group
This community is a place where members can discuss current events and weigh in on what's going on in the world.
deleted_user
What to do when insurance keeps denying to cover an MRI for me? I have so many neurological symptoms, and have had them since June. My doctor made an initial request, then an appeal, both times we were denied. First - how can insurance deny coverage in a case where there are unexplained neurological symptoms? Second, if the peer to peer my doctor is doing next fails to get the MRI approved, what should I do?? My doctor did suggest having one done on an emergency basis, at the ER, but what if I do that, and insurance won't cover it? Has anyone had this type of issues with insurance?
Posts You May Be Interested In
-
My 6mo twin DD's are EBF and just started rice cereal on the first. Everything has been going fine except this morning one of them had a diaper rash (lots of redness around her anus). I read this as one of the signs of an allergy. BUT I did just buy a different brand diaper yesterday (which they have used randomly before w/no issues). Do you think its the cereal or the diaper? Im ready to start...
Multiple Sclerosis Association of America/ MRI Diagnostic Fund
This association has a program to pay for an initial MRI exam to determine a diagnosis of Multiple Sclerosis.
I was diagnosed in the ER with suspected stroke or MS. My MRI was ugly, they told me on the spot that it was MS without a doubt.
After I was released from the hospital i had a ton of bills...so i immediately contacted all doc's, lab, MRI explaining that I did not have insurance and would they set up a monthly payment plan for me? They all did, except for the MRI center which had a charitable foundation to cover MRI costs for those without insurance. They gave me a form for their charitable foundation. i filled it out, qualified and they covered the cost of my MRI.
But my first MRI was ugly for MS, so there was no doubt that I would be a future customer for them and that I would get disability & medicare very soon.
If insurance won't cover it after you go to the ER, see if you can get on a monthly payment plan. Call the MRI center to ask what a cranial MRI costs. 6 years ago in WI a brain MRI with & without contrast was $1635.& the cervical spine was the same cost---the price must have come down in 6 years, but this is a low cost area-your area may be more or less expensive.
Try that MRI fund first.
..." http://www.needymeds.org/copay_diseases.taf?_function=summary&disease_eng=Multiple%20Sclerosis "...
pj - I have Anthem, it's a PPO plan. I'm not sure of the reason it was denied the second time. The first time there was insufficient information submitted by the doctor's office. I talked with a nurse at the insurance co and she told me exactly what info would be needed, so I emailed the doctor's office with the info she gave me. I then rec'd a call from the drs office to let me know they had submitted additional info and appealed. Then today, I had another call that it was denied again.
I actually have had the MSAA pay for a brain MRI. I had insurance that would not pay for one, and my doctor put down that I had "catatrosphic" coverage when she filled out the forms.
It is a fairly easy process, and you can pick where you want to have the MRI done.
This was not for an intial dx, but they paid for it as a diagnostic need for tracking MS...
Good Luck! All the forms are on the website, but I would call and talk to someone just to make sure you get everything in the you need the first time.
I sure hope you get this taken care of.. I have bcbs ppo plan and i have never had a problem, even my husband has had some with no trouble getting it paid, it is not anthem, but honestly something with how your doctors office is doing is getting it rejected, you know you can call bcbs too and ask them why it was denied, i sure hope you get this taken care of..... good luck let us know
The rep on the phoe told me straight out to go through the ER with a complaint that would cause them to do an MRI. I chose to go throug hthe MSAA.