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Any experience dealing with eviCore? Medical procedure denied!

Heart & Blood Health | Last Active: Apr 17 5:15pm | Replies (11)
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@maryc3d

I had breast cancer (stage IIB with lymph node involvement). I have really bad chest pain, and had a CT scan which showed, "Lytic lesions with ill-defined borders involving the entire chest with extension to and loss of integrity of the posterior vertebral body cortex. These findings can be seen with metastatic disease. Recommend PET/CT for further evaluation. " My oncologist ordered a PET/CT which was scheduled for 4/12 (tomorrow), but BP/AETNA/EviCore denied coverage, and the imaging center called to cancel the appointment. If EviCore reverses their decision after my appeal, the earliest the imaging center can fit me in is May 7th. This is a 3-week delay in treatment.

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andytheman | @andytheman | Apr 17 5:15pm

Those s o b ‘s got into my insurance company who now uses them for decision making. Luckily I had 2 MRI’s approved by them in a letter not my insurance company. Evercore is owned by another company so there are a lot of shareholders to keep happy
It’s like having a dis advantage plan.
They have denied people who needed lifesaving treatments. They say they are there representing the best and cheapest options. That’s bs to me. I hope my insurance company that I’ve had for over 10 years without paying for anything but my SS Medicare and my States Medicaid. My State has the best insurance in the country and we are all blue. Nobody is red. Even the mailman. Republicans try to get in but there is no support here for republicans. By the way UHC sucked when I made my choice to a 0 premium plan

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