Blue Cross and Blue Shield denied payment for the proton therapy Robert “Skeeter” Salim’s doctor ordered to fight his throat cancer. But he was no ordinary patient. He was a celebrated litigator. And he was ready to fight.
  • jordanlund@lemmy.worldM
    62·
    8 months ago

    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.

    • KevonLooney@lemm.ee
      32·
      8 months ago

      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.

      • mx_smith@lemmy.world
        5·
        8 months ago

        And then you probably have to pay thousands of dollars out of pocket before they will even see you for an MRI

    • shitescalates@midwest.socialEnglish
      13·
      8 months ago

      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.