Long story short, my mom woke up with vague symptoms, concerning for possible stroke. We have a genetic factor that increases stroke risk, and she has a history of a DVT. She was out of town, but she went to Urgent care, they recommended her to ER. She called her insurance help line and they verbally approved her to go to ER (she has record of the call, but idk if it was recorded).
The ER admits her to hospital for stroke work up given her symptoms and history. They want her to wait for an MRI, but it’s the weekend so this extends her stay for 3 days total. Turns out she’s ok! She followed the advice of medical professionals every step of the way and never pushed for more diagnostics than recommended.
Insurance just sent a letter saying they are denying coverage because the diagnostics and level of care were to much for the symptoms. This seems totally unfair because they approved her ER visit, and from there, she was just following doctors’ advice. Has anyone experienced something like this? Any advice? She is appealing, but I’m not sure how it will turn out.
She has Medicare + some private thing (not to sure).
submitted by /u/ganginguponthesun
[link] [comments]Long story short, my mom woke up with vague symptoms, concerning for possible stroke. We have a genetic factor that increases stroke risk, and she has a history of a DVT. She was out of town, but she went to Urgent care, they recommended her to ER. She called her insurance help line and they verbally approved her to go to ER (she has record of the call, but idk if it was recorded). The ER admits her to hospital for stroke work up given her symptoms and history. They want her to wait for an MRI, but it’s the weekend so this extends her stay for 3 days total. Turns out she’s ok! She followed the advice of medical professionals every step of the way and never pushed for more diagnostics than recommended. Insurance just sent a letter saying they are denying coverage because the diagnostics and level of care were to much for the symptoms. This seems totally unfair because they approved her ER visit, and from there, she was just following doctors’ advice. Has anyone experienced something like this? Any advice? She is appealing, but I’m not sure how it will turn out. She has Medicare + some private thing (not to sure). submitted by /u/ganginguponthesun [link] [comments]Read Morer/HealthInsurance