mri cancelled because insurance said no

[iteachfirst]

So, my mri was scheduled for today. Luckily, it was after work so I had not taken time off. About midday my doctor's office called to say my insurance was refusing to pay. They said they were working on it and should have an answer by tomorrow. So for now, we have rescheduled it for Friday. I wonder why? I have never had them refuse anything. The only thing I can think of is that maybe it is because my GP ordered it and not a neuro? I am frustrated. I know waiting is all part of this, but I was hoping to have results in hand by the weekend.

[lstrl]

Have you recently had an MRI? Aside from that, the only reason I could see them coming up with is that it would be cheaper for you to have it done at another place. In that case though, I would think your dr would have told you that. That's really weird. Hopefully you get it all straightened out soon.

[iteachfirst]

Thanks for the reply. I also thought that I could see their reasoning if I had one recently but I have NEVER had one. I am just going to let the doc's office work on it. If still refusing, I will call them to inquire.

[gomer]

Hi Teach..........

There is HELP$$$ with MRI for those who never had one. I hope one of the mods etc here will post a link or you.

Gomer Sir Falls-a-lot

[Seasha]

Yes - from the MSAA (MS Association of America) http://www.mymsaa.org/msaa-help/mri/

And tired teacher - do you know we have Assistance (sticky) under Medication and Treatments Forum? It gives phone # for various prescription and financial assistance, etc.

http://www.msworld.org/forum/showthread.php?t=121313

[iteachfirst]

Thanks for the help guys! I will certainly check out the links. My doctor's office was able to get it approved and it is rescheduled for tomorrow. Also, LOL,you got the tired teacher part right! First graders +Valentine's Day has kicked my tail!

[Seasha]

LOL - I'm sorry I got your name wrong!! Guess it fit for today anyway~ Happy Valentine's Day, iteachfirst! Good luck tomorrow

[iteachfirst]

No problem! It fits MOST days and probably would be a more appropriate name!

[bs957]

My Intro and also comment to iteach and lstrl

Can't explain why your insurance said no to the mri but I can tell you that different places do charge different amounts. I am one of those folks that are travelling this journey without medical insurance. Can't afford the health plan at work and make too much to qualify for financial aid.

I haven't posted much on these boards, (mostly lurk), but will tell you a little of my journey. Six yrs ago I came down with mild ON in one eye. That was when I had insurance. I had a bad experience with the opthamologist I was sent to as he dinked around for about six months before he was "well, I can't figure this out so I guess I'll send you to a neurologist". The neuro did a couple of tests and sent me for a brain & c-spine mri's . After two visits he (neuro) decides I don't have ms and sent me on my way since I didn't have any other symptoms. He said to let him know if anything changed.

Fast forward six yrs later to memorial day weekend of 2012. Now working for new company and no insurance bebefits. Woke up that friday morning and figured out real quick that I had a severe case of ON (think of looking thru a very dirty and very warped goldfish bowl). Also very intense migraine headache. Called my GP but couldn't get in to see him. Called my optometrist the following tuesday (since monday was a holiday), who had the sense to know that this constituted an emergency due to vision loss. He got me in that afternoon and confimed ON (Vision now 20/200). He got me in to an opthamologist early weds (vision measured at 20/400). Also confirmed severe ON but was uncomfortable rxing my steroids. GP still not available so went to urgent care clinic who rx'd me oral steroids, ordered a brain mri and referred me to a neuro doc. First appt with neuro doc was mid september.

Neuro doc ordered c-spine mri and plenty of bloodwork to be done. Also did a number of other tests including VEP. Remember, all this is without medical insurance. VEP confirmed ON (which affected both eyes). No other sxs to this point. Neuro sent me to neuro-opth at a teaching hospital who insisted on doing all bloodwork and vision tests again at his facility That was end of december 2012. I had brought mri films with me otherwise he would have insisted on that too. What a joke that appt was. He pronounced me "an enigma" and sent me on my way. Wanted me to see him in 4 months - we would discuss my migraine then. NOT going back there - waste of my time and $$.

Finally went back to the regular neuro doc to deal with my migraine (scale 7-8 out of 10 on a daily basis for 8 months) due to my wife's insistence. He found out I was taking 800 mg advil 3x daily and said that I couldn't do that anymore. Gave me an Rx for some meds (which took the migraine away within 4 days). Also discussed some of the memory fog and leg weaknesss I've since had. Also had me get new mri's of brain & c-spine, also thorassic & lumbar spines due to the new symptoms.

Forgot to tell you that original mri's and bloodwork came back non-remarkable and newest brain/c-spine was in a 3T machine. now waiting on the thorassic & lumbar to come back with results. At this point it's limbo-land for me.

Back to my original point. Since I don't have insurance, I have the ability to call around and ask for pricing on my tests. Found that the local hospital charges a good deal more than the local medical clinics. Because I'm a "no-insurance cash-pay", I've been able to get a rate of about 1/3rd of what the insurance companies are billed by the hospitals and doctors.

I Wish everybody well in their journeys thru limbo-land to a proper dx. Thank you for allowing my to share my journey thus far and giving me hope the times I've been down. Sorry for the long post.

[lstrl]

bs957, sorry to hear your story. I know all too well how frustrating it is to get in to see drs and then getting bad ones and having to change again. That whole repeating tests that you can provide results for is one of my biggest pet peeves as well. It's easy for them to say when they're not the ones footing the bill. I just want to scream at them that I'm not made of money when they do that.

It must be tough going about this without insurance, but what you said about price differences is spot on. I'm about to get a bill for my brain and c-spine MRI and with insurance, I'm still going to get charged $1000 and that's not including radiologist fees! A long time ago I had a shoulder MRI at one of those MRI places, and their fee (which includes the radiologist looking at it) was so much cheaper than at the hospitals!

I thought since I had my most recent MRI at the hospital I was working at, it wouldn't be so bad, but now I fear the day the bill comes in the mail (I have no way to pay that kind of money). I'll have to keep that price negotiating thing in mind the next time I need to have one. As much as I'm about to pay, I'd have been better off doing that at an outside clinic. Unfortunately, it's already done and there's nothing I can do about it now.

I'm starting to ramble now though. I really hope your most recent MRIs do show something so that you can start moving forward. Nobody wants a diagnosis of MS (or anything else for that matter), but if you can at least figure out what's causing the problems, you can start doing something about it. Good luck!