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Posts tagged ‘Insurance company’

With or Without Contrast


Holly Green

Sometimes, I feel like a ball that is juggled between the doctor, the insurance company and in this case,  the radiology department at the hospital. I took Stephanie to the doctor because she was having a migraine headache that had lasted for three weeks.  He referred us to a neurologist and we drove over an hour to Maryland to his office.  He gave her a few simple tests and told us that she did not have any neurological problems.  He wrote out an order for an MRI and told me to make an appointment and that’s when the trouble started.

I called a hospital in Leesburg to make the appointment and the lady asked, “Is it with contrast or without contrast?

“Uhh, I don’t know.  I think it’s without.”

“We need to know for sure before we can schedule the appointment.”

“Well, I’m pretty sure, since it’s for the brain that it is without.”

“We need to know for sure.”


I knew that contrast was a liquid given to someone who is having an x-ray but I was not sure what it was for.  I knew it had something to do with seeing the area more clearly and that was it. The lady on the phone told me I should be able to see it on the order and I could not tell what it said and she could not either, since I was not able to make out what was written.

So, I hung up and called the neurologist and asked them and the lady on the phone acted she did not know what I was talking about.  I had to try to explain it when I did not totally understand it, myself.  Finally, she asked and I was told it was with and without. OK, now I have my info.

I called and made the appointment, thinking everything was all right.  They told me to bring the order with me and I had it in my purse, safe and sound.

Well, have you ever heard of a doctor forgetting to sign an order?  I hadn’t either, until Thursday.  Terry, Steph and I went for the test.  We were signing in at the hospital radiology clinic and about to fill out a form, when the lady behind the desk said,  “Got to be kidding me.”

“What?”  We all said. “The doctor didn’t sign the order.  We can’t do the MRI without the doctor’s signature.” Terry was furious but discussing it calmly with her, which I could not do, at the time. I wandered over to the couch and sat listening to their discussion.  She tried calling the neurologist’s office but all three doctors were gone for the day-at ten minutes to five.  Therefore, without a signature, we were forced to go home and come back on Tuesday.

The next day, we made some calls and the doctor’s office called Terry back and told him that it was taken care of and we should be able to go through with the MRI on Tuesday. “We’ve just been really busy,” she told him.

“So, you’re telling me,” he said, frustrated, “that you were too busy to sign a doctor’s order.”

They sat there for a pause until she said, “Well, we’ve been really, really busy.” Terry just said OK and left it at that.

When Tuesday came, Terry called  me and told me that he was on the way to pick Steph up from school.

“Why?!?  I’m on my way, now.” He gave me a bunch of excuses about how we were late last week and how I might not come to pick her up.

“What?  I pick her up every day.”

Whatever!  He told me we could ride together and when I pulled into the school parking lot, guess who was pulling out?  What?!?  I followed them to the hospital and had to floor it sometimes to catch up with Terry and Steph.  When we got there, I was furious.  What kind of mother did he think I was?  Did I need to rethink my role as a mother?  We had bigger things to worry about, except for the argument we had in the elevator over it.

When we walked in and the lady asked if we had our order, we all started explaining at once how the doctor’s office was supposed to have taken care of that since last Thursday.  First, she looked like she did not believe us, then, she figured that since we were all talking at the same time, we must be telling the truth.  While she put her head down and searched through a stack of papers, I feel the tension between all three of us and I knew I was not the only one who was going to come unglued if she did not find it.

“Here it is,” she said, breaking the silence. Steph and Terry stood there, filling out her paperwork, with me feeling like the third wheel, until she lady told us that the order was only for “without contrast” and that the insurance company only approved “without contrast”.  I butted in and told her how I talked to the doc’s office and they told me it was for both.  So, evidently, he forgot to put “with contrast” on the order.  What is wrong with these people?!

We sat down to wait for her to be called and I discussed my dilemma with Terry that if I called the doc’s office, I would have to go outside, where I had service and they might call her back for the MRI and I would miss it.  Oh well. That’s when Steph started telling me about how Terry was mad the whole way there and convinced they were going to be late.  Now, it all made sense, (at least, with Terry).  He was worried about the test and was trying to control more things, so he would not feel so helpless.  Ohhhh.

“Why can’t you just calm down and trust that everything will be OK?”

How could I say that?  Call it “mother’s instinct”.  I just felt like everything OK and they would not find anything serious.  If you are a mother, you know what I’m talking about.  I wish the instinct reached to dads, too, for Terry’s sake.

When the technician called Steph back, he told us only one of us could go with her or none of us and she would be back.  Terry said he did not care but I wanted to be in there, so I went back.  The tech’s name was Matt and he was very nice and personable.  He asked us a couple of questions about her headaches and she mentioned being hit by the car when she was three.  That was when she had her last MRI and when the migraines began.  She was not having them for three weeks, straight, though. Matt was surprised that she was not permanently damaged by it and told her she was not finished with life; she had more to accomplish.  That was sweet.

He got her settled on the table and a cage around her head.  I would have died but she was fine.  I do not know how. I sat in a chair right outside the room, where he monitored her and I learned THE TRUTH about “contrast”.

“Most doctors don’t know everything about MRI’s and and don’t know the difference between contrast and no contrast,” he told me.  “They just fill out the order for both to make sure they get everything.  Actually, the insurance company does not approve the use of contrast because they know it is rarely needed for the test.  The radiologist goes along with the order for both or sometimes overrides the doctor’s order if he knows the contrast is not needed.”

If they were to see a mass, they would then add contrast to an IV and administer it to see what type of mass it is and if it is filling. (If I got that right.)  In other words, if we requested a test with contrast, we would be paying out of our own pocket for a test that was not necessary.

“Sounds like we were better off not having the MRI on Thursday,” I said.

That is because we would have paid hundreds of dollars for something that is rarely needed.  Boy, am I glad Matt told me that.  I sure felt better about Steph not being able to have the test the first time. I felt even better when he did not see any masses during the test.

Matt also told me that the radiologist, the person who actually reads the MRI scan, has 15 years of school and makes $150 K a year.  That’s a lot of school and a lot of money.  I think I’d rather listen to the radiologist rather than the doctor.

He gave me a lot of helpful info in a short amount of time and said, "Wow! I've never made it to a blog, before."

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