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MRIs Denied- then reversed

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    MRIs Denied- then reversed

    This week I found out that hubbys ins co. denied my neuros request for 2 MRIs. This has never happened before. I usually go once a year, and this is about that time.

    But now I see a MS Specialist, who wants me to have 2 MRIs every 4 months to do with being on Tysabri and the risk of PML.

    They even talked to him on the phone and he explained about the issues of being on this drug. Anyway, when I got the phone call, the lady said I could appeal it, and I said a big YYYEEESSS!!! She said she would start the paperwork as soon as we hang up.

    And she did! Within 48 hours she called me back and said they got someone else to review my case, and he overturned (right word?) the denial. YEE-HAA, their is justice afterall.

    On Monday I will call and talk to my neuros nurse (who has gotten a message left for her late on Friday) and see if she has got to call the hospital and get this set up this week.

    For awhile there, have to say I was scared. Now, I am thankful for that second person who had the sense to see how important these tests are!

    #2
    Woo hoo!

    Way to go Casino! And a big thumbs up for your hubby's insurance co......they didn't drop the ball and got you an answer for your appeal right away.

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      #3
      Way ta go CasinoKathy!

      Comment


        #4
        if ever you get an unwanted answer, appeal it. many times with a little explaining they will reverse the initial ruling! and kathy, .
        hunterd/HuntOP/Dave
        volunteer
        MS World
        hunterd@msworld.org
        PPMS DX 2001

        "ADAPT AND OVERCOME" - MY COUSIN

        Comment


          #5
          YEAH for your perseverence..always admired you so much Cathy!!

          But this is typical of many insurances companies. Hoping, I guess that you'll give up with the initial "NO"..but those who persevere, often with help of docs writing or calling the reason behind the test, proceedure etc.. helps to reverse these intial denials.

          Good luck. Let us know how it turns out ok hon?

          Hugs, Jan
          Go Pack!!!
          I believe in miracles~!
          2004 Benign MS 2008 NOT MS
          Finally DX: RR MS 02.24.10

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