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Replies to Msg. #1238397
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 Msg. #  Subject Posted by    Board    Date   
50622 Re: I can hardly wait to do this
   I use Aetna for my medicare and I have never been denied anything. I a... 		micro   6TH POPE   27 Feb 2024
 2:59 PM
50607 Re: I can hardly wait to do this
   micro:

Re: “One of these days I'll go back down to the cardiologist and have him check this out.. My CT scans are okay.. So what is up with the jolt ?”I'm sorry to hear about that.

When I wore my heart meter for two weeks, nothing was detected related to the symptoms I had described. But at a time when I'd felt nothing unusual, the meter detected ventricular tachycardia. My doctor said it didn't last 30 seconds - which would have put it into a different, more-serious class - but that it was still a potential risk. "A potential risk of what?" I asked. "A risk of sudden death." he said.

Okay. I guess that's a concern.

He said he wanted to do an MRI just to see what is going on. I received paperwork from my insurance company saying that it was denying the request due to insufficient evidence of a need but that the requesting doctor can appeal the decision within 14 days. A second letter said he can appeal within 60 days. The paperwork said that he'd been informed. I waited 14 days and heard nothing. I waited 35 days and heard nothing. I called my cardiologist's office and asked about it and they said, "You were denied? We were wondering about it. We received nothing!" So they filed a very late appeal and waited. The insurance company denied the appeal.

My cardiologist called to tell me and to say that he was just going to re-submit the request, including everything but the kitchen sink. TWO DAYS LATER I was called by my hospital to schedule the MRI. I told them I hadn't heard yet from my insurance company which had been balking at the request. They said, "Oh, they approved it already."

LOL. It pays to be persistent.

I'm not on Medicare yet. Good thing! I wonder how that would have gone. Is Medicare better or worse about approving expensive tests? I would think worse. After all, practically everyone who kicks the bucket is on it.