脖子疼，家庭医生让照MRI，结果保险公司拒

http://www.mitbbs.com//article_t/Medicine/31297465.html

发信人: polaris2255 (豌豆豆), 信区: Medicine
标  题: 脖子疼，家庭医生让照MRI，结果保险公司拒付，我该如果保护自己权益
发信站: BBS 未名空间站 (Sun Aug 30 18:37:23 2015, 美东)

最近总是脖子疼，肩膀肌肉酸痛，头晕，怀疑有颈椎病，然后在网上找了个华裔家庭医
生。看病当天，各种不靠谱，前台听歌玩手机吃东西，医生感觉也马马虎虎的样子，整
个诊所就我一个人，当时就想走了。跟医生说我颈椎不舒服，问她做什么检查。她说做
MRI吧，我问她需不需要先做X光（因为以前在另一个城市做腰椎检查，是先照X光，看
出问题，才继续做的MRi）。这个医生上来就说照MRI，当时就有种不踏实，但还是相信
医生是专业，可能有她的道理。结果照完MRi一周，现在收到保险公司发给家庭医生的
拒信，同时CC给我。
Dear DR.***
As discussed, you have withdrawn your initial notification request for this
procedure because after discussion, based on information provided, evidence
based guidelines and the benefit plan language, it was determined that the
imaging procedure initially requested CPT****_MRi of face and neck without
dye is inconsistent with evidence based guidelines for the above referenced
patient's clinical condition.Because you have withdrawn your original
notification request,by copy of this letter, your patient is being notified
that the imaging procedure originally requested is not eligible for payment.
The determination that imaging procedure initially requested is
inconsistent with evidence based guidelines is considered to be a
determination of medical necessity under **State Law and may be appealed as
detailed as below.

我的这个家庭医生都没给我打电话说这个事情，我现在该怎么办，感觉自己好无辜，我
没有非要做MRI，从没发生过保险公司拒付这个情况。明天周一，我该怎么跟保险公司
和家庭医生交涉，就怕这个医生推卸责任，难道我就这么无辜地做个全价MRI检查。

版上很多医生和相关专业工作者，能否给我一点解决这个问题的建议，谢谢大家！
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