I recently just had a 2D Echo done. This is the third time I had the exam done. My Doctor typically orders it for me due to tachycardia. I have anxiety and I get it when I go to the doctor. When he does my vitals, my heart rate increases. He orders the Echo to make sure there is nothing wrong with my heart.
The last time I had this test done was 2.5 years ago. It came back normal.
This time it did not come back normal. It was noted on the report that for my right ventricle, my cavity size is reduced and my wall thickness is severely increased.
I just got a letter from my insurance that my doctor’s request was denied.
It stated,
“Based on the information provided to us from your treating health care provider for Ultrasound of Heart with Color-Depicted Blood Flow, Rate, Direction and Valve Function, we have determined that the procedure(s) is not medically necessary because:
Your doctor told us that you have an abnormal heart rhythm (tachycardia). Your doctor ordered an ultrasound picture of your heart. This test should be used for certain types of abnormal heart rhythms. We reviewed the notes we have. The notes do not show that you have one of those abnormal heart rhythms. Based on the information we have, this test is not medically necessary for you.”
I’m considering appealing.
What should I do?
submitted by /u/Kylechs
[link] [comments]I recently just had a 2D Echo done. This is the third time I had the exam done. My Doctor typically orders it for me due to tachycardia. I have anxiety and I get it when I go to the doctor. When he does my vitals, my heart rate increases. He orders the Echo to make sure there is nothing wrong with my heart. The last time I had this test done was 2.5 years ago. It came back normal. This time it did not come back normal. It was noted on the report that for my right ventricle, my cavity size is reduced and my wall thickness is severely increased. I just got a letter from my insurance that my doctor’s request was denied. It stated, “Based on the information provided to us from your treating health care provider for Ultrasound of Heart with Color-Depicted Blood Flow, Rate, Direction and Valve Function, we have determined that the procedure(s) is not medically necessary because: Your doctor told us that you have an abnormal heart rhythm (tachycardia). Your doctor ordered an ultrasound picture of your heart. This test should be used for certain types of abnormal heart rhythms. We reviewed the notes we have. The notes do not show that you have one of those abnormal heart rhythms. Based on the information we have, this test is not medically necessary for you.” I’m considering appealing. What should I do? submitted by /u/Kylechs [link] [comments]Read Morer/HealthInsurance