6 month follow up MRI to diagnose*DENIED

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ScredMomma
ScredMomma Member Posts: 9
edited May 2016 in Employment, Insurance, and Other Financial Issues

I've now had an abnormal Mammo, ultrasound, & MRI. Due to another condition, I can't have biopsies immediately & whenever anyone wants. Radiologist & Breast specialist both agreed that a follow up MRI & Mammo at 6 months would be the best route for me. Now, Our primary insurance says I do not meet the medical criteria for an MRI. My Medicare approved it. (Completely opposite of what I thought would happen.)

Now what? Just let these changes continue until my next yearly mammogram? So tired of being sick and fighting insurance companies.

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  • JoniB
    JoniB Member Posts: 346
    edited May 2016

    I'm sorry that you find yourself in this position. Every insurance company had a procedure for filing an appeal. I think it best that your doctor does this on your behalf as he/she can state why this screening is so crucial for you. My second cancer was caught on MRI and not US or mammography so I urge you to file an appeal.

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  • ScredMomma
    ScredMomma Member Posts: 9
    edited May 2016

    The insurance company forced my Dr to consult with theirs. This, then led to the forcing her to withdrawing my MRI request as 'I did not fit the medical criteria.'

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