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Old 11-18-2013, 05:33 PM   #77681
 
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If I were a maniac I would bomb stupid CIGNA. Every year since brain tumor surgery I have an MRI to see if it grew back and to see if a second brain tumor that I have is growing. So, first the MRI was authorized.

After the MRI was performed, I get this letter that they are not reimbursing anything (although they had authorized it) because I didn't see my brain surgeon in advance of the MRI - the first I have heard that I am supposed to do this.

Each year I see the brain surgeon AFTER the MRI - he wants to see the results to see if my tumor grew back or if tumor #2 is growing and I need more surgery. Otherwise, why have the bloody MRI?

I totally despite health care insurance providers. Don't tell me it is authorized and then after it is done tell me it isn't authorized for some bogus reason - stupid, stupid, stupid criminal thieves. I will be out more than $3000.

On behalf of everyone who suffers at the hands of these crooks, I am enraged.
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Old 11-18-2013, 06:47 PM   #77682
 
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Can you contest it? I know I had some issues with insurance not covering things but when I called back someone usually could help me or tell me who to call. I hope the pre authorization will carry some weight in this.

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Old 11-18-2013, 07:15 PM   #77683
 
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Quote:
Originally Posted by curlypearl View Post
If I were a maniac I would bomb stupid CIGNA. Every year since brain tumor surgery I have an MRI to see if it grew back and to see if a second brain tumor that I have is growing. So, first the MRI was authorized.

After the MRI was performed, I get this letter that they are not reimbursing anything (although they had authorized it) because I didn't see my brain surgeon in advance of the MRI - the first I have heard that I am supposed to do this.

Each year I see the brain surgeon AFTER the MRI - he wants to see the results to see if my tumor grew back or if tumor #2 is growing and I need more surgery. Otherwise, why have the bloody MRI?

I totally despite health care insurance providers. Don't tell me it is authorized and then after it is done tell me it isn't authorized for some bogus reason - stupid, stupid, stupid criminal thieves. I will be out more than $3000.

On behalf of everyone who suffers at the hands of these crooks, I am enraged.
You may have already tried this, but sometimes it helps to call and talk to someone and explain. I once had an insurer try to charge me for a pap smear......I let them know real quick there was no way in hell or on god's green earth that I was paying for that since it was preventive and it was supposed to be covered. Just let them know what the deal has been every time before. If you make it clear you're not backing down, they generally will. Or at least this has been the case every time I have contested something.

Unfortunately it's a necessary evil. Maybe one day people will consider a single payer system, it would make things much simpler. Or at least universal coverage. Baby steps.
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Old 11-18-2013, 08:07 PM   #77684
 
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Thank you very much for responding Perri P and CurlyArca. It helps a lot to be able to vent and get some feedback.

Believe me, I am contesting this. In the letter denying me any reimbursement, they say the MRI isn't medically necessary because I didn't see the dr. first. The surgeon requested it!

I had a life threatening tumor, an 8 hour surgery, 5 subsequent surgeries, it took a year to recover, and I have a second tumor. The MRI is to is check that tumor 1 isn't growing back and that tumor 2 is stable. Not medically necessary???

The entire health care mess makes me insane.

I'll post back eventually and let you know the outcome. Thanks again for responding - it helps.
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Old 11-18-2013, 08:48 PM   #77685
 
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Sorry, Perri. That looks like a pain in the booty, pun intended. I know exactly how uncomfortable PF is. I had some removed long ago. Some other treatments probably could have been attempted first but the doc went straight for surgery. I am glad they have been going through different options.


I am sorry to you too, CP. Insurance can be such a pain. My provider puts you over a barrel non stop. I had to pay for my MRI. It was recommended by my doc, done in my local hospital, but conveniently no one who reads the MRI results in my area are in network. They ask you to bend over any chance they get. I agree with Perri and Arca. Contest, contest, contest and best of luck. It does sound like you have a pretty good chance of getting it straightened out. It is necessary and a surgeon is a doctor.
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Old 11-19-2013, 01:26 AM   #77686
 
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CP, I don't know how things work with your health care system but would your surgeon back you up, maybe give you a letter to show them explaining the situation?
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Old 11-19-2013, 03:31 AM   #77687
 
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Also, CP, my mom had a friend who worked in Insurance and they were told to deny every third claim (or some other arbitrary number). Her advice was to contest everything. Also, I'll echo what starmie said. I know doctors who have actually called on behalf of the patient in things like this. Big hugs

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Old 11-19-2013, 07:28 AM   #77688
 
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I was just asked the most impossible question. Name a good, recent, comedy... I had to think for quite some time, and that sucks because I love comedies and am no where near above crude ones, and neither is my friend. Ones with in the last 5 years or so came to mind (and I even had my "meh" moments with them.) I loved Due Date, because they way Zack's character Ethan walked the dog was fantastic. Leash high, head up, comb in pocket. That and I love Robert Downey Jr (and refused to be mad at him over a joke made on a fake twitter account). Forgetting Sarah Marshall. Yeah, parts of that killed me while other parts slowly died. Russell was great as Aldous Snow. "I've lost a shoe, have you seen it anywhere? Excuse me, Misses. I've lost a shoe, like this one. It's like this ones fellow. It's sort of an exact opposite, not an evil version, but you know a shoe like this." I liked the first Hangover, Date Night, My Best Friends Girl. Sorry, Claudine. You seem to have a reaction to Dane Cook, but I loved it when he kept trying to (he thought easily) offend Kate's character by playing 2 Live Crew and taking her to strip clubs and kept failing miserably. Rambling over... I've gone blank after that, and he has seen all of them.
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Old 11-19-2013, 07:31 AM   #77689
 
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^^^Crazy Stupid Love!

Steve Carrell - adorable

Ryan Gosling - shirtless


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Old 11-19-2013, 07:35 AM   #77690
 
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On the flip side of that, if you ask me to name good comedies of the 80's and 90's... I can go on for days.
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Old 11-19-2013, 07:37 AM   #77691
 
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Quote:
Originally Posted by rouquinne View Post
^^^Crazy Stupid Love!

Steve Carrell - adorable

Ryan Gosling - shirtless


Yep, I recommended that one. He had not seen it. *Though my first thought was shirtless Ryan, and he won't be interested in that.* I even had to recommend Ted. I'm 50/50 on it. At least parts of it made me laugh hysterically.

& PS- Like me, he is not the biggest Steve Carrell fan. I really don't find him to be that funny, with exceptions of a few movies. I actually prefer him in more serious roles. I have not yet had the courage to tell my nephews that I hate The Office. They think I would love it, and I should/typically would, but I don't.
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Old 11-19-2013, 08:51 AM   #77692
 
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CP, sorry you are dealing with those stupid heads

PerriP - your pjs are cute and they look so warm and comfy!
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Old 11-19-2013, 09:09 AM   #77693
 
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My coworker told us that her hubs signed up for a Vitamix class for the blender they just purchased. She was upset that they cancelled the class, charged her card and didn't tell them. um, the store burned down. Perspective people!!!!!!
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Old 11-19-2013, 09:39 AM   #77694
 
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I think I am going to ask the bestie to help me wash my walls. Haha. He will love that. Hey, I helped him clean his room and his parents house, top to bottom, more times than I can count. That includes washing walls and doing windows with newspaper. It's time for paybacks!
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Old 11-19-2013, 10:01 AM   #77695
 
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I need to go back to the Dollar Store. I found some adorable glitter bird ornaments and started working on my smaller tree yesterday. I need more

Say It.  I Dare You.-imageuploadedbycurltalk1384880316.489272.jpg
Say It.  I Dare You.-imageuploadedbycurltalk1384880335.517755.jpg
Say It.  I Dare You.-imageuploadedbycurltalk1384880356.055382.jpg
Say It.  I Dare You.-imageuploadedbycurltalk1384880382.403867.jpg

I got them in silver, pink, dark and light blue. I already had dark and light blue ball or or ornaments and icicles. I'm still lacking enough to do the tree properly.
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Old 11-19-2013, 11:24 AM   #77696
 
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Hi Fifi, PerriP, Starmie and Scrills - happy to get your responses! They encourage me to contest.

Scrills - perfect description - they are stupid heads. I swear they need brain surgery more than I do.

I have a letter approving the MRI, signed by a Dr. Allen and a letter 2 months later denying the MRI signed by the same Dr. Allen. I sent copies of everything to my surgeon and hope he will contest it.

What a bunch of dodos. Your MRI is "not medically necessary." No, I just had it for the thrill. They strap me in rigidly and immobilize my head with a cage. It's like being in a tomb except for the crashing loud noises. I'm claustrophobic and have to be sedated. It's just so much fun.

Well, on the plus side, I have a crush on the surgeon (he saved my life, he's an angel, he's cute and he hugs me) and I get to see him in two weeks. Hee
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Last edited by curlypearl; 11-19-2013 at 11:39 AM.
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Old 11-19-2013, 11:34 AM   #77697
 
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Ohhh I love loving a doctor. I had a mad crush on my gynecologist lol. My insurance changed so I can no longer see him.

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Old 11-19-2013, 12:08 PM   #77698
 
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i bought $50 worth of decorations this weekend myself, but i don't have my tree up - yet!

it's very tempting, but i don't take it down until January 10th or so and that's a long time to have a big white tree in a corner of the room!

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Old 11-19-2013, 01:28 PM   #77699
 
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^ I was not going to buy new ones, but I could not pass the birds up. Too cute!

I know what you mean about having them up for a long time. Idk when I will do my main tree. I would like to get it done soon so everyone can see it when they are here for TG. That is the only Holiday when all of my family comes in, but I don't want to look at it that long either. The one I am working on goes in the hallway so I don't see it unless I am going to the bathroom or bedrooms.

I love my Aunt so much. I had completely forgotten about some pink and purple ornaments she picked up for me last year. I got those out and put them on. I have some more she has gotten in the past that will work, too. I just need silver. I used to do an all white and silver tree but most of silver ornaments were broken. I like to do the hallway tree in cute and fun ornaments that do not break.
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Old 11-19-2013, 01:41 PM   #77700
 
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I wonder if my co workers cat has stopped climbing her tree yet she had to completely re-do it. She would go to work, come back home, find all the ornaments on the floor and a cat head sticking out of the middle of the tree. Lol

I never had that problem with mine. They like to quietly sit under them and adore the tree, but they will unwrap every single present. That is one of the reasons why I switched to gift cards.
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