3 ms·
My wife has had a string of back problems and insurance has denied everything the first time it is sent to them. Every MRI, back injection, physical therapy cov
by dr_orpheus 7y ago
My wife has had a string of back problems and insurance has denied everything the first time it is sent to them. Every MRI, back injection, physical therapy coverage was denied the first time. Each one, we and the doctor had to fight to get it approved.
For example, the first back injection was denied the first time one the basis that "it was not inhibiting her daily function". The notes from the doctor submitted to insurance specifically said "the pain in her back is inhibiting normal daily function." They reject it just to see who will fight back. Furthermore, insurance is only required to look at notes from appointments and will ignore comments from doctors if they aren't tied to anything. So in order to fight an insurance claim requires another appointment with the doctor which costs more money just to get the insurance company to look at the claim again and get it approved.
It's a terrible game.