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EY...yes I realize it is treatment that saves/helps...but you have to do the tests to determine the treatment. And no I didnt die obviously,but I do have problems stemming from it still..2 yrs later.

My Dr. had reasons for ordering the CAT scan. I didnt ask for(or demand)one.

My point is..when a Dr deems something is necessary,it should be respected. Possibly a second opinion needed to ensure the Dr. was correct. But healthcare should be up to the Dr and not some pencil pushing insurance rep who knows nothing about either medicine or the patient.



Both you and SexDJ have clearly demonstrated what is wrong with our current health care system AND why insurance companies feel the need to second guess physicians better than any town hall meeting ever could.

Thousands upon thousands of Humana customers get CT scans every single day of the week. There is no shortage of people getting CT scans reimbursed from every single insurance company in America every single day of the week.

If your doctor has been practicing medicine for more than about 2 weeks he would have known what Humana required to see on your paperwork to justify reimbursement. I do not believe that he did not know that the paperwork he was submitting would be denied (unless he had only been in practice for a couple of weeks). Even then, all he had to do was submit an addendum or call them on the phone. Most likely he was contacted by Humana to tell him they were denying the test that he ordered. Many times the insurance companies will even place a telephone call directly to the doctor and speak to him person to person to inform him that the test was denied and why.

Why should insurance companies and government agencies (Medicare, Medicaid, VA, etc) second guess doctors? Because the guys like SexyDJ's buddies order useless shit in the mistaken belief it will protect them just in case they get sued 10 years from now, or are just too lazy to do the right thing. In fact they get downright hostile if somebody like me comes along and dares to suggest they just practice good, honest medicine and cut the crap. That is why insurance companies second guess doctors--they brought that shit on themselves (or at least some of them did, and forced the rest to suffer the consequences of their shitty ways).

Insurance companies get sued just like doctors do for failing to provide necessary services. They cover their asses by demanding that a doctor document reasons why a test is necessary and you bet your ass if a doctor has clearly documented why a CT scan of the head is needed, they WILL provide it; and if he has not, they won't.

There are a million examples of insurance companies screwing people over, Cameron, this just ain't one of them.

I have nothing against strippers (hell, I LOVE strippers) and I am no apologist for insurance companies (hell, I HATE insurance companies), but in this case they almost certainly were not at fault.

If you feel so strongly that a CT scan will fix your life and cure you, why don't you just shell out the $200 bucks yourself and solve all your problems? If you had just saved a little over $8.00 a month, you could have paid for one by now. We're not talking about a heart & lung transplant here.

P.S. Why Natasha Richardson should not have gotten a CT scan at the ski resort
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--Some of us look for The Way in opium and some in God, some of us in whiskey and some in love. It is all the same Way and it leads nowhither.