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Originally Posted by AaliyahLove
originally the chiro. But I had both the chiro and the doctor take seperate xrays and they both told me they PERSONALLY spoke w Aetna on the phone and told them what the prob was (t4 bone slipping backwards, possible disc prob) and that it was a new problem. They both have been keeping in contact with me and can't believe Aetna rejected it either.
So your personal feelings about chiros aside, do you REALLY think who ordered the MRI orginally had something to do with them rejecting it? I mean they have the xrays and same results from BOTH doctors..
And if it DOES have something to do with is, why wouldn't they come out and tell me?
I'm not tryin to argue I'd really like to know what you think, I think I rly need to start educating myself about this kinda crap ugh
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I am not really trying to argue with you, merely trying to help for the next time.
My personal feelings about chiropractors is based on my professional experience with them . . . . and actually, now that I think about it, I had an opportunity to get involved in an insurance scam many years prior to that. The centerpiece? A chiropractor.
I initially asked you if Aetna was a PPO or an HMO, because I am not really sure if they offer both or not. I have been researching a group plan for my company and Aetna HMO was one of the options.
With an HMO you must start with your primary care physician. If they refer you to a chiro it looks to me like you only have to pay a $15 co-pay with 20 visits a year. Of course, since you have a $5k deductible it is entirely possible that the plans are completely different, but I would not think it would be that different.
If you had a PPO then you don't need a referral, however, [every plan I saw] had at least a 25% coinsurance AFTER the deductible for 24 visits a year.
So, my first question needs to be addressed first. But my honest thoughts are that if the doctor put in the script instead of the non-doctor it would have had a much better chance of going through. Why Aetna did not say that? Perhaps because the question was not posed to them in that manner.