MRI denied but already performed

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Hi everyone,

I’ve never been in this situation before and I could use some advice. I have employer insurance through Cigna (in-network). I apologize if I use some terms incorrectly.

For the past 5 months I have been going to a rheumatologist to find some answers. Bloodwork was done as well as basic hip X-ray that commented about possible impingement.

My hips were x-rayed because they have been having arthritic aches that make it difficult to do physical labor and sleep through the night. Myself and my doctor didn’t feel that those pains could really be explained with impingement, so he sent me off with a referral for an MRI.

When the diagnostic imaging company (in-network) called to tell me that the preauth would still be pending on my appointment date, I made a dumb decision to lock in my appointment and sign a waiver to have it done anyway. I am glad to have done it because it turns out I have a complex labral tear but I’ve also never needed a pre-auth for a procedure before.

I just got a letter from Cigna that says they won’t be covering the MRI because my doctor didn’t send in the right documents.

What is your recommendation? Should I wait for my doctor to respond to my insurance or should I call my insurance company to explain (and maybe eviCore as well?)? I have the online report from my initial x-ray … would I have to pass a screenshot of that along?

The letter also says as long as I receive approval, they are willing to cover any imaging done at the diagnostic imaging company I went to. That seems promising for my case?

Lesson learned that I should wait for the approval next time …I hope my insurance won’t hate me because it’s looking like cardiovascular lupus might be a possible diagnosis for me in the near future …

Edit: I am located in AZ

submitted by /u/EnduretoSurvive
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Hi everyone, I’ve never been in this situation before and I could use some advice. I have employer insurance through Cigna (in-network). I apologize if I use some terms incorrectly. For the past 5 months I have been going to a rheumatologist to find some answers. Bloodwork was done as well as basic hip X-ray that commented about possible impingement. My hips were x-rayed because they have been having arthritic aches that make it difficult to do physical labor and sleep through the night. Myself and my doctor didn’t feel that those pains could really be explained with impingement, so he sent me off with a referral for an MRI. When the diagnostic imaging company (in-network) called to tell me that the preauth would still be pending on my appointment date, I made a dumb decision to lock in my appointment and sign a waiver to have it done anyway. I am glad to have done it because it turns out I have a complex labral tear but I’ve also never needed a pre-auth for a procedure before. I just got a letter from Cigna that says they won’t be covering the MRI because my doctor didn’t send in the right documents. What is your recommendation? Should I wait for my doctor to respond to my insurance or should I call my insurance company to explain (and maybe eviCore as well?)? I have the online report from my initial x-ray … would I have to pass a screenshot of that along? The letter also says as long as I receive approval, they are willing to cover any imaging done at the diagnostic imaging company I went to. That seems promising for my case? Lesson learned that I should wait for the approval next time …I hope my insurance won’t hate me because it’s looking like cardiovascular lupus might be a possible diagnosis for me in the near future … Edit: I am located in AZ
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