Out of Doors and Network

Out of Doors

I waited for temperatures to rise above freezing so I could ride outdoors today. I went out to get my bike and the water bottle I had left on my bike was hard as a rock.

Luckily, most of the ice on the roads and trails had melted. There were a few icy patches on the Mount Vernon Trail on the way up to the stone bridge from Alexandria so tomorrow morning’s bike commuters should be on the alert.

The ride went fine. I was a little underdressed though. After about 20 miles I started to think about the warmth of home and hearth and headed back from Alexandria. I stopped to buy some things at a drug store. I stood in line for about five minutes. My lower back started to ache. Can’t wait until I get that needle next week!

My wonky leg continues to wonk. No big surprise but I don’t need painkillers as long as I stay off of it. This is perfect weather for a walk in the woods too. Dang.

The irony of all this stenosis business is that about five years ago I decided to increase my hiking specifically to offset the osteoporosis that can set in when you do only non-weight-bearing exercise like bicycling. Damned if you do. Damned if you don’t.

I am happy with 27 pain free miles on the CrossCheck today. The next few days will be warmer so I’ll probably ramp up the distance. (I’m over 500 miles for the month as it is.)

Out of Network

The day after my MRI I received a document from my insurance company agreeing that the procedure was medically necessary and would be covered. (The MRI center had already been given the green light.) I have been getting emails and robocalls from my insurance company telling me that hospital MRI centers are often not regarded as in network. The insurance company told me that I “could save hundreds of dollars” if I went to another MRI facility.

Funny. The hospital MRI center told me I was covered and had to pay only a $100 co-pay.

After the third communication from the insurer I went on line to check things out. The insurer’s website clearly states that the MRI facility I went to was in network.

My guess is that other non-hospital MRI facilities charge the insurance company less. So they are trying to steer me to a place that saves them money. As long as I go to an approved facility, I pay $100. If they didn’t want me to go there, they should take it out of network or charge me a lower co-pay to go somewhere else.

Am I missing something?

 

 

 

3 thoughts on “Out of Doors and Network

  1. You are missing nothing. That is the problem with the medical system. You can have the exact same operation or pro endure like a colonoscopy with the exact same surgeon at two different hospitals or at a hospital versus an ambulatory surgery center and the cost can differ by thousands of dollars. When I did colonoscopies at Memorial, I had a patient whose procedure co payment was $300 in the hospital or $50 in the outpatient center. My suggestion is,call your insurance cop a y before any elective procedure to find out if it will be covered and what the copay will be. This,will all change for you next August when Medicare kicks in.

    1. What is bewildering is that the insurance company website explicitly states that a lumbar MRI at the facility I went to costs me $100. Same as a dozen other facilities. So why are they calling and emailing me?

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