Insurance Company Denied Ct Scan
I felt as if i was.
Insurance company denied ct scan. Insurance companies in the us are just straight up trash. I called and spoke personally to the physician reviewer and explained my rationale but his decision was immutable. Insurance companies aren t the nicest when it comes to approving scans. Nov 2015 may 28 2016 4 26 am.
My first pet scan was denied and my onc had to call their medical management md to provide justification for the pet. The pet scan can have false positives as stated before so it s good to compare it to a ct scan. Insurance denied pet scan. 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.
It can detect developing diseases at an early stage unlike ct scan where detection can be a little bit late. I missed the call bac from the nurse but the message said that because i had stage one cigna denied. I had this conversation today with a doctor whom i suspect doesn t treat living breathing patients anymore. Insurance companies often deny studies that are ordered for us until the ordering doc calls or provides more info.
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. You should also review your summary plan document spd as a start because you need to find out who is responsible for pre auth. I ordered the ct scan which the insurance company summarily denied. I have cancer that may have spread and insurance denies coverage claiming it s unnecessary.
Pet scans can see. 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. 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.
If your doc really wants a pet they can send them a letter trying to get it approved. As i sit here in the middle night not being able to go back to sleep my mind jus keeps spinning. 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. The advantage of pet scan over ct scan is that it can expose the metabolic changes at the cellular level of the body.
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. 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. I too was denied a pet scan ordered by my physician denied by the insurance company saying that it wasn t medically necessary. I called my oncologist today to see when my 3 month post treatment scan was scheduled.
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