- Thread starter
- #21
- 630
Update!
Coventry denied the doctors appeal, stated he has to do therapy for 4 weeks. The therapy consists of strengthening exercises 2 hrs a day 3 days a week.
The doctor said if his suspicions are correct and it is a torn meniscus the exercises will be painful and of no help, he communicated this to Coventry and they said at the end of therapy if no better we will approve the MRI.
I am at a loss, the client just called and said he can't miss this much time from work and if they did the mri when he first went and if he needed surgery he would be walking and recovering now.
Now if he does the therapy and then has to have surgery it is setting him back 2 more months.
If he pays for the MRI out of pocket it will not be credited to the deductible, that has been verified.
Sounds like if the doc suspects a torn meniscus how can Coventry insist on the therapy if it could cause more damage. As I said before, sure a company has a right to maybe question a procedure but come on! If the doc insists they should just authorize it before the condition gets worse. Who is better qualified to determine whether the test is necessary, the person who actually SAW the patient, or someone in an office far away. Also, seems to me it could cost them more in the long run, even with the higher deductible.
I just got my Feb comm statement from Coventry so I am even more pissed off hearing about this, and this isn't even my client. Nice to work harder for less money huh? Especially if the client wants to blame you too.