At War with my HMO.. again !


Well, back to a war with my HMO. After taking two mts to bloody find me a Chiropractor, allowed 3 “office visits” only, which means no X rays, no therapy etc. Now they dare refuse to permit anymore as the file doesn’t show it’s medically necessary !

Now mind you, I have no doubt he would have dearly loved to X ray me up one side and down the other, but they would not have paid for that, so can hardly blame him for the lack. He did give me some minor treatments anyway, even though he was not really being paid for that. Yet when he asks for more… they say no, because no proof of need has been show.

This is a real cart before the horse situation here, in that they will NOT pay for the diagnostic workup, yet will deny me seeing him, for lack of it. So its war, yet again, from his end and mine. As the reason I was sent to him in the first place, was well documented.

I have already seen a nero doc about this, he said see the Vein specialists. OK, saw them.. they told me, nope not the blood flow, see a Chiropractor. Now I have to ask a stupid question here, how much more proof do they need ?  Almost a year I have been at this mind you and then after all that, they up and say, it doesn’t meet the “needs” test.

Ready to flat pull out my hair here !!!

BB

Esta

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6 thoughts on “At War with my HMO.. again !

    • Nice to meet you Ginger… bummer on joining the FMaily.. but knowing is power and once you understand it, it DOES get easier.

      And this is medicaid, so its even worse, but the HMO is a mandatory and they just add a layer of complex to it all.
      BB
      Esta

      • Thanks for the welcome, I hope it will get easier for you, somehow. Insurance companies run you through the ringer, too. They declined one of my meds because I “don’t suffer from bleeding ulcers,” which was the whole purpose of the medication… To PREVENT bleeding ulcers. If it’s not one thing it’s another I suppose.

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