MRI ordering question and ASHN

[Guest guest]

Oh man here we go again with ASHN. This one was partially my fault (i guess) I don't order MRI very often, but had a disc herniation that required a look see. The patient had providence ins. under good ol ASHN. Well, being a physician, it didn't occur to me for one second that i wasnt allowed to order an MRI and that of course the patient's primary physician would know more about the patient, the condition and the need for the diagnostic test then myself.

I called providence to see if i could send him to Legacy E. and got an authorization number and the approval to continue. The patient mentions to me that they stuck him with the bill. I called and was informed that Legacy was out of network and I had no right to order the test. They say that they are doing us a favor by paying the out of plan price because of this. They claim i can appeal this decision, but i wanted to run this by you folks to hear your opinions on the matter.

Thanks.

Dr. ph Medlin D.C.Spine Tree Chiropractic1627 NE Alberta St. #6Portland, OR 97211Ph: 503-788-6800c: 503-889-6204