neurosurgeon referral denied.

[crabbymoonmama]

I was diagnosed last week with Chiari 1 malformation with a herniation of 7mm. My insurance denied the referral to the neurosurgeon. I was thinking of appealing it but from what I have read about my insurance they never approve appeals either. I am feeling very frustrated not sure what move to make next..please help.

[selmaS]

  Even if you can not get to a Chiari specialist due to your medical INS I am sure one will be willing to consult with your Dr and offer some insights ....many will review your MRI for free while others charge a nominal fee.

[crabbymoonmama]

Thank you ladies. My pcp doctor called my insurance and got them to change their minds. But it is not a chiari specialist..just a regular ns. I dont have very good insurance so i doubt there are any chiari specialist available to me.

[selmaS]

  Hi and welcome to the Chiari forum.

This is going to be a bumpy ride...and getting denied is not the worst thing that can happen.....so take a deep breathe and look at what info you have....do you have copies of your MRI that detected your Chiari...do you have the report?

If not, contact the facility that did the studies and request both the MRI and report for ALL testing you have had.

Then once you have them make copies,,,,,and send to a true Chiari specialist ...once they see it they will be able to tell you if you are a surgical candidate and they should be able to help you get your INS to approve a visit.

There are many types of INS and sending an appeal should be done.....I am sorry you have to deal with this aspect of trying to get help.....

Hang in there and know you are not alone..

[Elisaandbucky]

I, also would urge you to ask the doctor who referred you about this. Chiari is a very specialized study for neurosurgeons and many neurologists do not stay current with the recent research. Is the neurosurgeon that you were referred to a Chiari specialist? If so, he/she may be able to help with some of the navigation. Please keep the forum posted about your progress.

[Lynnrae64]

What insurance company? What was reason for denial? I would be discussing this with the referring doctor. Possibly the notes were not specific.