What's The Deal with all these MRIs?

Hi osso!

Crazy, huh? I'm just having to do all the silly steps.

With that sequence of recommendations, you really need to get the ombudsman to look at it. That's reprehensible. I'd suggest someone make a call this week.

also - do this asap

http://www.oregon.gov/DCBS/Insurance/gethelp/Pages/fileacomplaint.aspx

there is also this option

http://www.oregon.gov/DCBS/Insurance/gethelp/health/Pages/externalreview.aspx

This is very tacky of them, to say the least. The insurance co., I mean, not the docs.

Please be aggressive, my mom lost over three months fighting with insurance before she got her diagnosis, and since her cancer was fast moving we ended up figuring out that that three months probably cost her a least a year a probably two of life because of the delay. It was slowed down by Chemo once she got some.

I thought that the refusal to do a biopsy was liability bullshit but after looking maybe that Doc has a legit patient outcome argument for not doing it. Are you angry about the refusal?

Wow, thanks ehBeth. I'll check all that out.

I'm going to bide my time for another week or so before I get to riled up. My doc thinks we have a good chance of getting an exemption. I booked the appointment with the o.o. about a month ago and still have a couple of weeks to wait.

I have a really good friend who was an administrator with the VA for many years and she said she would help me with further appeals, etc. if I couldn't get an exemption through the usual channels.

It really is reprehensible. We pay a lot for our insurance and have a pretty high deductible and this treatment feels like nonsense. Because of the ACA we have to completely redo our insurance at the first of the year and there's no telling what will happen after that so I'm trying to get things taken care of ASAP.

I wasn't mad at all. I thought it was very ethical of him.

The trouble is that the tumor is inconsistent so testing one part of it won't tell us everything. He thought even taking several samples wouldn't be enough to give us a good idea about it. He was also worried about "seeding" it.

I appreciated his honesty. He didn't want to put me through something unnecessary.

They really don't think it's cancer. They seem to be more worried about nerve damage.

I told Mr. B that it was probably a parasitic twin and that completely freaked him out!

Anyway.... I've completely hijacked Linkat's thread. I just wanted to point out that MRIs are a good thing as they can reveal unexpected problems that might be related to injury. I'm glad I brought it up though because ehBeth had some great advice!

<nods>

this is what I wondered about

Do you at least have evidence that the insurer has had a senior level review of your file? if not, you need to really kick their asses

contact with the ombudsman would at least get that to happen

at every insurer I've ever worked at/with, ombudsman involvement means a vp and senior reviewer have to review the matter being questioned

I'll start digging into it all this week. I've been seriously sick with a c. diff. infection for the last month and haven't had the energy to deal with it at all. Now that I'm mended from that I have the energy to tackle some of this.

Thank you so much for all of your very good advice and direction!

Glad you know this stuff, ehBeth. I agree speed matters in a situation like this.

I'm trying not to swear.

I'm rather testy in that my parents were insurance poor, long story, and I've been insurance poor, long story. I take it there is a lot of that out there, though maybe things are better now, somewhere. But to be stiffed when you have good insurance is freaking.....

Love your humor.

There are times when hijacking is a good think .... a thread that is... and this is one of them.

Thinking of you

Plus I dont think that the answer to the original question is known. Not enough effort has gone into study, and the picture appears to be complicated.

1) we love to get treated with high tech the more expensive the better devices for several reasons

2) defensive medicine

3) In America MRI and CT machines are high profit to build and per use charges

4) doctors and medical companies like to show off that they have high tech, the more expensive the better

5) America has the most machines per capita other than Japan, and when you have it you gotta use it

6) people now have this fetish with trying to live as long as possible, and they tend to want to use all advantages to get there

7) I am fairly certain that owners of scan machines get very pissy when they dont have high utilization rates for a few reasons, all of them to do with money, and so they pressure providers to send more patients.

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I am glad Boomer still likes us enough to tell us about stuff like this.

Someone has a sense of humor with the Senfield tag.

The good news is -- my Texas Republican (not the nutty, fundamentalist kind) mother is sharing Bernie Sanders health care quotes on Facebook in light of all this. She's even thinking of voting for a Democrat next election.

All I had to do was point out that she gets to take advantage of that darned socialized medicine known as Medicare.

We have decent health care coverage. Two years ago it was great. We were one of the kind of families that got screwed up by the Affordable Care Act. Our premium, co-pay and deductible all went up. I really didn't mind. It was a hit but not so big that we couldn't deal with it. I want everyone to be insured. I just really didn't expect the company to thumb their nose at me when I got sick.

Thanks, Linkat.

I hope your daughter is okay.

I probably would have been really annoyed if I'd paid (our co-pay was about $700) to have an MRI and they said "Yep, it's a sprain" but I'm not a talented athlete with a potential scholarship on the line. It's probably a good thing to have some base line images of any areas giving her problems.

These young athletes on elite teams are pushed really hard and the fact that they play through pain that would sideline most of us is crazy. Mo's best friend plays on a super-elite basketball team. He broke his wrist playing football this year but he refuses to stop playing basketball despite the cast on his arm.

Good news! My appointment with the specialist has been approved!



I really like a lot of the people here, some of them feel like family. Even though I don't post that much I usually look in here every day.

I've watched a couple of people I know play out their health dramas online and then get depressed when they didn't get enough "likes" or comments after some update. So they posted more updates, and more people experienced "sick-friend fatigue" and stayed away. It was a vicious circle; almost like watching a gambler think they're going to hit it big on the next hand.

I don't want to be "The Sick Girl" in any corner of my universe but this thread seemed like a good place to share my thoughts about medical tests sometimes being the right thing to do.

Wishing you the best with your health drama. This getting older stuff is not meant for sissies.

I'm 'blessed' with having excellent coverage and treatment from the VA at as top-notch VA hospital here in So FL.


FWIW, I can't ever receive an MRI, as I have a defib-pacemaker.

I can relate, though at this point I've been in 100% remission from an uncommon type of Non-HL for 12 months. My most recent PET scan results are due in a few days. My health drama (hopefully) is winding down.

that is terrific news

best to know what's going on eh

wishing you the best and glad you are finally getting the attention you need.

Good news - no other damage - she just needs some PT for a few weeks as her knee and stuff around that area is really tight. So looks like she may be able to try out for high school basketball.