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  #31  
Old 01-20-2011, 04:12 PM
Miss Foxy
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[QUOTE=DonnaMaria;148643]
Quote:
Originally Posted by Primadawn View Post
Keep us in the loop--we're all pulling for the tiny dancer! I wondered about a tear when you were describing it too--with the "pop" and all...
She sounds very determined--I'm sure she'll be willing to put in the work to make her dream a reality!


Thanks ladies! She is determined but getting really frustrated! I am as well! Listen to this bulls**t.................

We had the appointment for the MRI...........then the insurance company calls and tells me that they won't pay for the MRI until Jessica has seen an orthopedic surgeon. This is AFTER they told me to take her to her regular doctor so she could get the MRI. They changed their mind…….they want her to see a specialist first.

So we cancel the MRI appointment. I take her to the specialist………
and the first test he orders………………………

an MRI………………………..

I just wasted a week of her recovery on insurance red tape. What a bunch of bulls*#t! I'm fuming!!!!!!
You on HMO or PPO? I work in this industry.. Anything that requires pre-auth (mri) will need to be approved by your IPA or PGA (medical group) regardless of a specialist. I wouldnt call it red tape it should be noted in your contract EOC.. Never listen to the doctors office morons they say anything to get you in.. Ask your insurance company to outline where in your EOC you can review the protocol. Your insurance called you? We never call patients we just flat out deny claims or tell the docs office it won't be covered.. That's odd..
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  #32  
Old 01-24-2011, 12:49 AM
DonnaMaria
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Thanks Melissa. I will do that. I have blue cross/blue shield of nj and i don't need a referal to see a specialist but the specialist wouldn't make the appointment until Jessie saw my family doc first. My family doc set up the appointment for the mri since he said the specialist would need it.

yeah the insurance rep called me. they have done that a few times actually. right before my stress test and then when corrie had a few infections.

I'm just frustrated. She has missed three weeks of dance. No one is accepting new patients right now. I had to call three offices before I could find one that accepted new patients. Then they only offer limited appointments for new patients at odd times........it's all just frustrating.

Meanwhile I am trying to hide the fact that I am really worried that she tore something. Her ankle is still swollen and purple..........
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  #33  
Old 01-26-2011, 11:15 PM
DonnaMaria
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well................we got good news today..........and bad news.........sorta....

the good news is that Jessie has a Syndesomosis ligament injury or a "high ankle sprain." apparently a ligament that runs between the bones in her ankle was torn and she needs to wear a cast for the next 6 weeks. right now she doesn't need surgery but if the ligament doesn't heal within the next 2 months she might need it. and it means no dancing at all for at least 2 months. before the accident she was dancing 4 nights a week for 1 1/2 to 2 hours.........so she is really depressed............

but it could be worse..........
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  #34  
Old 02-10-2011, 11:07 PM
DonnaMaria
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