Back in March I had my annual mammogram. It included a sonogram since I’d had some pinchy feelings in my breasts and they are dense, so easier for mammos to miss things.
A few weeks ago I got a bill for the sonogram, which was unusual. I called the radiology center (only had to wait on hold for four minutes) and was told that Medicare had started routinely rejecting these as not medically necessary, and that I should have my doctor send Medicare a letter explaining the medical necessity, and the center would follow up. Today I called center’s customer service again (only had to wait on hold for five minutes), of course got a different representative, so I had to explain the situation twice. This representative said she would pass on the information.
Later I ran into a neighbor who said her method of fighting the insurance rejection was to try to get the name of the doctor who works for the insurance company who made the “not medically necessary” judgment and get her doctor to call that doctor. Would that really work?
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