Insurance companies and their little tricks....

Can you move this to the water cooler please..thank you!

EDIT: My doctors office is the scumbag in all of this mess after further investigation.

Well as some of you may know my knee is jacked up. It has been swelling for two months and finally on Sunday as I was jogging I felt it pop several times in the joint line. Bad pain and I couldn't walk. 4 days later and I am up and walking a bit, but not well. Well my insurance company denied my mri yesterday so my doctor called back this morning to inform them I am having trouble walking and they denied it yet again. They said to use anti-inflammatories and an over the counter brace for a month before rescheduling an appointment. I am just so pissed.

I rarely go to the doctor and the only costs my insurance has ever incurred from me over the past 14 years is an appendectomy surgery when my appendix burst 10 years ago.....and they deny me a simple MRI! Now I am in limbo at work. I am friggin tempted to slap a brace on the darn knee and just go back to work. I am at a loss as to why they denied me.


EDIT: My doctors office is the scumbag in all of this mess after further investigation.

 

Wow that sucks. I would not just put a brace on and go back to work. You are going to do more damage and have more problems in the future than you would if you just take care of it now. I havent really dealt with insurance companies before but can talk to a different person to try an approve it? Or could the departments insurance cover you to get an MRI and get everything check out?

 

Brett,

Can you call the insurance and demand an explanation?

 

That totally sucks. Hate it when the companies pull **** like that. Hope everything turns out alright and you recover quickly.

I'll help turn this into a bowhunting post so it can be in this section instead of the "Water Cooler" Really to bad your not gonna be able to get out and walk around the woods for awhile now scouting for the upcoming bowhunting season. LOL

 

I hate health insurance companies, and I'm an insurance agent. Sorry to hear that Brett. I'd call and demand a EOB from Blue Cross.

 

, thank you sir! The thing I have going for me is I've had knee injuries before and know the rehab protocol inside and out. My legs are already strong and I just need to strengthen little things here and there to stabilize my joint. As for the potential meniscus tear, nothing I can do can fix that if that is the problem....a simple little mri could tell so much. I am sure the folks at work are going to love this one.

 

Sorry to hear about your knee... sounds like a potential meniscus tear like you say.

Can you call your insurance company and ask them if they have a license to practice medicine in your state? If not you may have some recourse... you (or your doctor) could accuse them of 'practicing' medicine without a license - and that's against the law (in most states anyway... isn't it?). Seems to me that might be a way to get your MRI approved.

Best of luck to you.

 

What insurance do you have?

 

This gets even better. I called my insurance company and they have no record of my doctor calling them to speak with their doctor to authorize the mri after it was originally denied. They still have in their computer notes as to why it was originally denied and nothing else. I sure hope the people at.my doctors office have a great lunch bc they are going to receive one heck of a phone call at 1 pm.

 

Get em
Sorry to hear of your frustrations though! I recently had a similar BCBS experience. NO FUN! Bunch of A holes
They sure don't mind takin my money each week though

 

Give 'em hell. You're dealing with people who's primary job is to deny claims. Private ins. companies can be bad and Medicaid/ Medicare are a real PITA to deal with.

And just wait... it will get worse yet.

 

I will give them heck in about 10 mins Christine. Once they understand I found out they lied to me on the phone this morning it should get interesting. I put two and two together this morning and it sure did not add up to four.

 

Can't wait to hear how that call goes

 

These kind of stories are about to become the norm.

 

hmmm.....that's rough!

so what did they say!!!!

 

And like w. most big companies, he's probably still on hold waiting for the next available associate!

 

Wasted my entire day dealing with my doctor and Anthem insurance.

My doctor's office which is supposed to be legit, lied to me two times, one lie of which stated Anthem's protocol on knees and mri's has dramatically changed recently. Well I called Anthem and spoke to several people and they stated their knee policy in regards to mri's has not changed in years. They then went on to say my doctor called Anthem and asked to override the initial mri denial....there are absolutely no records stating any call was ever made and as a matter of policy they always document that call and the resolution as a result. I will walk into my doctor's office tomorrow to get re-evaluated, obtain a doctor's note excusing my absences at work, and then never step foot in there again. I cannot stand liars and will not do business with them, ever. I have wasted 6 days dealing with this crap and it is getting old.

Anthem has been very helpful all day. I stand corrected on their performance, it was my doctor's office and the staff.

 

Well glad to see you made progress and hope you have better luck with your next doctor.

Sent from my DROID3 using Tapatalk 2

 

That's really interesting (to me, because it's not my knee ). If you can find a place to do a review on that Dr's office, put in your experience.

When I went in to an ortho for my shoulder, there was only one in the area that took my ins. (which happened to be Anthem, LOL). He was 35 miles away. Anyhow, he said, without doing an MRI, that my shoulder needed surgery and no amount of therapy would help it. He then said he wouldn't fix it unless I quit shooting a bow because "You're just going to tear it up again". Needless to say, I never went back to his office. Never got my shoulder 'fixed' either but I did find a chiropractor who was able to work it enough that I can still pull back a bow and I can feel my fingers again. :D

Good luck with your next doc.

 

Those sneaky doctors. Sure wouldnt trust them to evaluate or do surgery on me, never know what they're hiding from you. Like a towel or a medical tool.