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My PCP won't refer me for specialist or authorize MRI

Spine Health | Last Active: Apr 19 9:33pm | Replies (35)

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@babs10

@bebold Ah - maybe THAT is the difference - it's not Medicare requiring the referral, it is the specialist! Thanks.

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Replies to "@bebold Ah - maybe THAT is the difference - it's not Medicare requiring the referral, it..."

That's why it was so easy to get one from a walk-in clinic. Esp we have ortho walk-ins. Good luck. Be

Medicare advantage plans have to approve everything and I heard they are refusing nearly 75% of so much stuff. Before I retired, I had BC/BS as an advantage plan since I was on SSDI. I needed a rotator cuff repair. 4 parts to the surgery and BC only approved 3 parts. Surgeon said he wouldn't go in and not fix it all. He kind of did a sneaky thing with a friend radiologist, rewrote the MRI findings to match their language better and got it all approved. I was grateful.