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.

2 comments:

Star Lawrence said...

From a white paper I got today:

Re superinfections from MRIs:

. Rothschild's experience has been that essentially 100% of the table pads over 2-3 years old are torn or frayed. These damaged pads must be discarded since they are impossible to adequately clean due to the sponge-like core being exposed. Even worse, MRSA can penetrate frayed fabric covers that appear intact. Torn and frayed pads are an area that is often overlooked by MRI centers. In response to these concerns, Dr. Rothschild has developed a technique of using a black light to identify biological contamination as well as a magnifying glass to see torn and frayed areas on MRI pads.

“There is nothing in my practice I am more concerned about than my patients developing an infection by a superbug like MRSA, especially after an MRI,” warns Richard Nolan M.D., an orthopedic surgeon.

raGing said...

thanks Star. that clears things up.
all this time I was blaming the Indian owned & run imaging center referred by my ins carrier.