Monday, November 10, 2008
Bad for the image
…HA has written that she thinks MRIs are being prescribed like little liver pills. But she is not sure how she feels about the recent WSJ story that more insurance companies are reviewing them, thus foiling docs, increasing office paperwork, and perhaps shortchanging patients.
…Under HA’s plan, her copay for an MRI is a thou. She is pretty likely to be half-dead or braindead before opting for one. But some people can’t wait to jump in the tube.
…Anna Wilde Mathews wrote the story (Nov 6, 2008), in which the biggies—Aetna, Wellpoint and Cigna--were nailed for hiring radiology-benefit managers to review requests. Their justification apparently is that docs don’t really know how to use this new technology.
…One woman had backing from her surgeon, oncologist and radiologist—but was turned down for an MRI to see if her cancer had returned. The reason was American Society of Clinical Oncology guidelines for women “under surveillance.”
…Another patient cited was supposed to have a PET scan every three months for two years, but the approvals delayed them a month or more and eventually a new tumor developed to a large stage.
…If you need a scan, see if you can find out what the professional society involved says. American Cancer Society is one, American College of Radiology is another.
…You can appeal. But a recent story about Arizona, at least, said that 95% of appeals to the state insurance board by doctors were nixed with almost no investigation.
…Yipes, people. We are out here trying to stay alive.