So I am trying to get my yearly abdomen MRI scheduled for liver screening and my doctor, an interventional radiologist, that wrote the order for the last 4 years MRIs approval was turned down by my health insurance company because HE is no longer affiliated with my hospital group that provides the insurance even though I scheduled the MRI at one of the group hospitals!

My options are too try and schedule at one of the hospitals in his group through my secondary insurance, BCBS, which should cover that but with a separate deductible limit I would have to pay for the entire thing out of the pocket OR see if my oncologist can write and order for an MRI that they will approve which he has done in the past and he is still a part of my hospital group which is what I am going to try next.

I could get a CT without any approval needed and cost me only $75 copay but when they do that the radiologists always reports he sees things but can't rule out tumor so recommends an MRI anyway which I might have to do if they won't approve MRI order from my oncologist. I have talked to nurses from a couple doctor offices telling me that in the last few years it is getting more and more difficult to get an MRI approved.

Around here hospitals seem to change ownership fairly often but weird it's like they don't trust the opinion of my doctor anymore all the sudden.

quote:

Around here hospitals seem to change ownership fairly often but weird it's like they don't trust the opinion of my doctor anymore all the sudden.

^^^^^^^^^
It is not about trusting the doctor. It is about money and control. I have run into this with my healthcare. I once had to drive 40 miles to see a physican and pay out of pocket. Believe me I raised hell with the medical director. Made no difference.

Health care is inappropriately named. It’s neither about your health nor your care. It’s about money.

I had BCBS and they were the worst to deal with.

Every year filling out school forms I have to put down our preferred hospital. And every year I’m tempted to just write down “the one across the street from Fawcett”. The irony is that Fawcett Hospital has been Fawcett for the 23 years I have lived here and our preferred hospital has changed names at least a half dozen times.