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this post was submitted on 07 Nov 2023
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Had a similar problem with Aetna earlier this year.
I had snapped an achilles tendon. Physical therapy wouldn't touch me until they ran an MRI to determine the damage.
Damage that can't be seen on an xray because the achilles tendon doesn't appear on an xray.
Aetna denied the MRI, need to to an xray first. An xray that my doctor, my physical therapist, and I all knew was pointless.
And the MRI machine they cover has no appointments for 6 weeks. There are probably 3 other MRIs on the drive to that one sitting unused. You sit there and wait for no reason. Welcome to America.
And then you probably have to pay thousands of dollars out of pocket before they will even see you for an MRI
I went through the same thing on my knee. 3 pointless appointments and two months to get to the MRI, that should have been the first step.
How can they be saving money by adding extra steps to my diagnosis? It's not just the insurance companies that are the problem. Medical providers have their own schemes to milk the insurance for more money.
They kinda save money when people give up on getting care at all. Insurance companies should have no input in any diagnosis.
So providers price MRI sky high, to encourage the insurance company to put us through all these hoops. The whole system is broken.
The more they can do the more they can charge and or deny
Went through that twice with shoulder injuries.