Insurance Company Denied Ct Scan
I felt as if i was.
Insurance company denied ct scan. My docs do a pet ct scan meaning when i go in for a scan we do a pet and then a ct scan with the same machine. Anyone have ct scans denied not once but twice even after pathology report confirms cancer. If your doc really wants a pet they can send them a letter trying to get it approved. I missed the call bac from the nurse but the message said that because i had stage one cigna denied.
Also please be aware that there is a new scan out called a pet mri but i am not sure how insurance companies are going to handle that. Insurance denied pet scan. My initial reaction is that pre authorization for this ct scan is your responsibility not the hospital doctor and that if true this may be the reason it was denied. Insurance companies in the us are just straight up trash.
I called my oncologist today to see when my 3 month post treatment scan was scheduled. I asked if there was additional recourse available to me and he advised that i could request a peer to peer discussion when i could discuss the case with another physician. However the picture presented by pet scanning is not as detailed as ct scan due to the fact that the picture in pet scan only exhibits the area where the tracer is. I have cancer that may have spread and insurance denies coverage claiming it s unnecessary.
The records may also help. I called and spoke personally to the physician reviewer and explained my rationale but his decision was immutable. My first pet scan was denied and my onc had to call their medical management md to provide justification for the pet. Insurance companies often deny studies that are ordered for us until the ordering doc calls or provides more info.
I ordered the ct scan which the insurance company summarily denied. I too was denied a pet scan ordered by my physician denied by the insurance company saying that it wasn t medically necessary. I had this conversation today with a doctor whom i suspect doesn t treat living breathing patients anymore. Insurance companies aren t the nicest when it comes to approving scans.
As i sit here in the middle night not being able to go back to sleep my mind jus keeps spinning. The pet scan can have false positives as stated before so it s good to compare it to a ct scan. With insurance companies most times you need to hae a ct scan first. Log in or sign up to leave a comment log in sign up.
It can detect developing diseases at an early stage unlike ct scan where detection can be a little bit late. Pet scans can see. You should also review your summary plan document spd as a start because you need to find out who is responsible for pre auth. Even if your insurance company does not yet have a policy that requires pre authorization for mri and ct scans if you have a ppo provider preferred organization or high deductible health plan in which you are responsible for a portion of the costs your out of pocket expenses will be dramatically higher when these studies are performed in a hospital.
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