Re: adenomyosis and US
From: art fougner, md (evsono@pipeline.com)
Tue Feb 13 14:18:40 2007
More than likely, this is another in a long series of Insurance 3 Card
Monte scams.
Just my opinion - I could be wrong.
Art
At Tue, 13 Feb 2007, Atkinson, Samuel M wrote:
>
>There are published articles on the use of ultrasound to look for
>adenomyosis signs suggesting but not diagnostic of adenomyosis. A
>former resident is supposed to be collating findings and writing another
>article about studies we have done here at Brody SOM. MRI is highly
>accurate in diagnosing adenomyosisl. We have been very surprised when
>MRI's have been ordered for various reasons and have a good radiologist
>report that there is adenomyosis present and have subsequently found it.
>There are also reports that MRI is very good in distinguishing
>leiomyomas from adenomyomas. It is
>ironic that insurance companies do not want to prior approve
>hysterectomies with a diagnosis of adenomyosis by ultrasound that we
>cannot prove without a big biopsy but also want to use US findings to
>not insure pt.
>Are they choosing to Not insure her at all? Or just exclude future
>hysterectomy from coverage. If it is the former, she has some other
>factor, such as excess utilization of services is also going on.
>sAm
>
>-----Original Message-----
>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Joanne
>Bulley, MD
>Sent: Tuesday, February 13, 2007 2:32 PM
>To: Multiple recipients of list OB-GYN-L
>Subject: Re: adenomyosis and US
>
>Thanks everyone.
>
>She has never been without insurance and will have no lapse between
>insurers. With the HIPPA law - there is "supposedly" a requirement to
>be able to get insurance - under the "portability" clauses. Her local
>Anthem BlueCross accepted her with the same US report a few years ago.
>
>So it appears it is against even the HIPPA law for them to deny her this
>coverage. Especially as this BCBS did not "rate" for the prioir US -
>why should another BCBS product deny her (they didn't even offer a
>"rated" - hight cost - plan).
>
>As we all know: the insruance companies do whatever they want and it
>doesn't have to be reasonable or fair.
>
>Joanne
>
>At Tue, 13 Feb 2007, Richard Chudacoff, MD wrote:
>>
>>like they need a reason to deny her coverage?
>>
>>--
>>Richard Chudacoff, MD, FACOG
>>-sent from my Treo 650
>>
>--
>Joanne Bulley, MD, FACOG
>Solo gyn
>Keene, NH USA
>
--
art fougner, md
"May The Wings of Liberty Never Lose a Feather." - Jack Burton
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