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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


I considered getting the CT scan on my own,but my Dr. (who yes,has been practicing much longer then 2 weeks) was ordering it just to be safe and not because any actual danger was seen. But a CT scan or MRI would have been a help in determining how to treat the ongoing problems I was having from the head trauma. Without tests, all they could do was guess.

I'm sorry you seem to have such disdain and mistrust for doctors...the Dr. that I went to had saved my life by FINALLY correctly diagnosing and treating a chronic condition that I had been born with,but had been misdiagnosed my whole life. Gone untreated long enough,it is fatal...so I have a lot of trust in him and his staff. And while the testing may not have been mandatory for my health...he wouldnt have ordered it if he did not think it was warranted. As he told me...there are so many things that can happen with a head trauma and it is better to find out ASAP rather then let it get worse. I even asked whether he recommended my paying out of pocket for it, and his advice was to wait a little while and if my symptoms got worse, or new ones developed, to have it done and he would fight with the insurance company to cover it.

This is far from the first time this particular insurance company has screwed me over. My last one..Aetna..was wonderful. I had no complaints whatsoever about them,and was very upset when the company switched to Humana. Humana also killed my father-in-law by denying him medication and testing that would have saved his life. Theres no way he could afford any of it without insurance coverage.

So IMO....Humana is the fucking devil and I continue to hope...as others in the company are now seeing the same problems with them...that they will cancel and switch to a different carrier.

But in general..I trust a doctors opinion about what I need and what should be done FAR more then I trust some pencil pushing bean counter at an insurance company.


And that link you posted...1)it dealt with trauma victims in rural areas. Natasha was not in a rural area. and 2) since I dont know the exact details of her case,I cant say exactly what should have been done. My point in mentioning her was that after suffering the head trauma, she waved away ambulances because she felt fine. Hours later she was dead. There is often a lot more going on with head trauma then there initially appears to be. This is far from the only case where someone has suffered head trauma and thought they were just fine (after all...most of us,at some point or another, hits our head on something and just shakes it off with maybe a headache or knot on your head being the only aftereffect) and later developed serious problems from it.
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