Real things that happen when you try to get an MRI covered by insurance: - Recommend useless alternative forms of imaging - Delay approval with things like mandatory physical therapy - Force the patient to drive an hour or more to a facility that they choose - Load up Texaco Mike’s schedule until he has nobody available to work the Texaco
Oh I know it's true. My Best Friend has mild stenois in her neck. This hurts her shoulder & sometimes her wrist. She did get an MRI. Now the insurance is paying for PT which isnt helping
Ugh so true and happens very week in our clinic! When things take way too long like months, we just tell the patient to go to the ED because "it's the worst headache of their life," or "paresis got worse." We would let ED know and see/admit right away, it's terrible terrible waste of ED/hospital resources for something that could have been taken care of as outpatient. Ugh...
Haha I got one immediately. And at a hospital. All I had to do was break my neck in two places, my back in seven, and puncture both my lungs. Just got to learn how to game the system like me.
I dont know what I expected in the comment section, but not this. Well played sir. Although on the serious note its good to see you can watch CZcams and type comments after all that.
And MRI work? The man can image a pigeon at 150' away. That is to say, he does image pigeons at 150' away. Turns out you can adjust the strength way up on them-also, he mounted a gun-sight on it. Needs to be inside the machine, I hear you ask? Oh no. Texaco Mike widened the aperture so much that technically, the whole world is in his MRI (but especially the pigeons).
He's actually not even kidding about Texaco Mike, my friend had to get an MRI and asked me for a ride. We show up to an nearly empty parking lot next to some random office building. In the parking lot was some mobile home looking thing. Its legit like 200 square feet and its just an MRI machine, the tech and the computer. Best park is that for all that, he still had to pay part of it out of pocket, even though he was using the outhouse equivalent of an MRI facility. This country is a legit joke
Just because it's in a trailer doesn't mean there isn't a 3T MR scanner with the latest software packages which take awesome pictures. I personally refuse to read the crap 0.5T or 1T "open MRI" images sent from imaging centers with beautiful waiting rooms. Don't judge a book by its cover: let me determine the quality of the imaging. Sincerely, a radiologist
@@yonpark6245 Yep. I used to live in a rural area, and we had an old bus/motor home thing that came around to do mammograms. The images they took were actually better than the closest hospital. Can't always judge a book by its cover.
@@sithembisobuthelezi903 True. However, in Queen BunnyFooFoo’s case she mentions rural area. There are many people in rural areas that if the traveling mammo machine didn’t come to them, they would be unable to get their mammograms done. Lesser of the evils is the trailer, which is far better than stage IV breast cancer as an incidental finding down the road.
@@KB-ct7th Absolutely that van was a lifesaver for many women. My other point is that just because a place has fancy carpets and decorations doesn't mean the care is any better. I now live in a good sized city, and my old provider's company recently built a brand new fancy building to move into. Of course now the company has to pay for that building by jamming as many patients thru as possible every day. My provider was great, but he's now only allowed 10 minutes per patient by corporate.... and that 10 minutes is after I spent an hour in the waiting room. I switched to a doc in private practice. His office is old, yet his revisits are 30 to 40 minutes....longer if you have a problem. The bean counters have totally ruined healthcare.
I just really cannot believe for a country as wealthy as the US that this actually happens and you don’t have Universal Healthcare. I also can’t believe that Americans are seemingly content and happy with the system given that election after election people don’t vote for candidates promising UH and candidates don’t feel the need to stand on the platform of supporting it. Utterly baffling.
@@GiraffeFeatures I am very unhappy with a LOT of the stuff we do. I try to vote but nothing ever changes. I am so worried for my future and the future of my people but I feel completely powerless to do anything about it. There are too many people that think we're perfectly fine, all that needs to happen is to "pull up your bootstraps", work hard, and become Christian and everything will fix itself.
As someone who used to work at an imaging clinic, this is straight up facts. Will never forget when a patient with a history of cancer was denied for an MRI despite their doctor wanting to do a routine check. Apparently insurance companies would rather you start suffering first than catch it early and prevent it getting worse. 😐
When I was booking appts for MRIs sadly the ones with cancer us usually have to wait months before they can get one and this is in Canada free healthcare. The ones who required MRIs for their joints like knees, elbows, ankles etc usually get theirs right away and the patients don’t appreciate nor care. Most would no show. They’re not paying out of pocket and they don’t have to pay a no show fee so they tend to take advantage
No insurance companies would rather the sick patients die quickly so they don't need to pay anything for necessary preventative treatments. Had this issue with BF getting insulin for his diabetes. US and doc fought for 5 months with the insurance company. Snuck the meds over from Canada paying out of pocket, but hey it was $500 cheaper there than in the US. Insurance randomly approved things after 5 months, apparently this is common to weed people out. Then only the ones who are still persistent after that time are approved. All I could think when I learned this was "weed out"? You mean die?! Bc that's what not having insulin will do when you're diabetic.
@@sophiathore3538 reminds me of my surgery professor. *points at fuzzy barely perceptible radiolucency* “ah yes, osteosarcoma” my brother in Christ, that is a cotton ball
This came at the perfect time. My dad’s been trying to get an MRI for years, gone to so many hospitals, but they never did it. Long waiting list, and expensive too. Recently he basically lost power in his legs so we took him to the hospital in a wheelchair. They admitted him in for a week and then did the MRI. That’s “all” it took.
Really sorry to hear about your Father, I hope he’s doing ok? Conversely as a European when my Father suffered from Transverse Myelitis and had to learn how to walk again, he was in hospital for 4 months completely free of charge, given Physio and OT and was in a specialised rehabilitation ward with specialised Nurses etc. Lost count the amount of CT and MRI scans he received, and x-rays. Our only complaint and his too was that he didn’t get as much Physio as he would have liked/needed so as a personal choice he picked up extra physio at his own expense but in comparison to your situation that seems unimportant! I feel extremely lucky that we have the system we have when I read stories like this!
Extremely accurate. As part of my follow-up care for this cancer I had, I required PET scans. & the guidelines were clear that annual pet scans were warranted... The insurance said, "nah you good bro". They didn't approve it. Sooo they're really out here practicing medicine trying to determine what I should and should not get. It's actually insane.
Very thankful for living in Sweden! Fell of a horse, banged my head, a bit of a headache, went to the ER, saw a nurse, saw a doctor, was given an MRI upstairs, saw the doctor again, paid 70$. No insurance company involved, the doctor just got me the care he saw fit. Yes we pay quite high taxes but, when you get sick you can always get the right care no matter your income or insurance.
I hope someday America will be like Sweden. I saw a CZcams video a remote viewer said we would be like Sweden in about 2050 do to sea levels rising and climate change. I'll be dead by then but I hope we really do get it America system sucks and it could be changed they think it can't be but it can be it will have to be also housing needs to be changed. I'm 66 and living in a motel by the freeway I'm homeless. I believe dr. Robert schoch and Edgar Cayce.
Our system is so shity. I went to the county for destitute people to get some blood pressure medicine and the doctor wouldn't give it to me. I begged her for it because I said I won't even be able to get here again there's no public transportation in the suburbs of Houston I had no friends and no good family. I went without blood pressure medicine for two years and it enlarged my heart and now I have congestive heart failure for no other reason than I couldn't get simple cheap blood pressure medicine. Now I'm homeless because I can't get subsidized housing.
You want to know something else that makes me mad I lived in a UFO hotspot in 1969 in Roseville California I saw anti-gravity aircraft every night for four years while I lived in that house. Not just me. America does have a secret space program and they put billions of dollars into it that's why they don't have money for their people. I kid you not my ex is a psychologist ex fiance his best buddy moved out to where I used to live then called him long distance after a few years and said I'm seeing UFOs out here. And my ex said that's what Kay said over 50 years ago. I'm just saying I know we've got the zero point energy I know it but only the shadow government the black government has it the real government doesn't have control of it that I know we have it and we should be spending it on the people of America. Not secret space programs.
Americans will never accept funding a system like Swedes via taxes. The word taxes is is more offensive than the n word in American culture. Keep up your Swedish value system: "We all do better when we all do better."
How is there no class action lawsuit led by every doctor in the US suing the insurance companies over practicing medicine without a medial license? This is madness!
Totally agree! I am Canadian and went down their as a nurse and the bull shit nonsense people were spewing about how bad socialized healthcare is was ridiculous! Totally indoctrinated by false information that was fed to them by capitalist assholes wanting to continue to profit from healthcare. It’s actually so sickening to me! Don’t even get me started on the fact they only have 12 week maternity leave - I was off paid for 14 months!
Technically speaking the guidelines for insurance are created by insurance-employed doctors. Then it's up to some sort of clinician (I dont know level of education) to determine if your request meets said guidelines. So it's less practicing medicine and more auditing someone else's medicine. At least that was how it was done 5 years ago before I switched employment from a top 5 insurance to work for the enemy (a hospital position that is the exact opposite of my previous position).
As a UK medic, prior authorisations make no sense to me! Like, we ONLY do scans etc if it's genuinely medically necessary and the best option. The fact that a non-medical person who doesn't know the patient, hasn't clinically examined them, and can just reject a necessary scan simply based on monetary value is just incomprehensible to me?????
This is so true! As a physician I hate these prior authorization conversations. It’s such a waste of my time and I feel the insurance company is making stuff up. Thank you for this funny but so true video. We need the public to know how broken the system is. Sincerely, one burned out physician
I hate that its all about greed and money in the end, humanity goes down hill. Like we could all improve our life quality if we are kinder to each other but the "psychopaths" and "narcissists" are ruining it for all (selfish power hungry people etc).
Same. My most recent prior Auth denial was acute rehab admission for a patient after hip hemiarthroplasty with history of CVA and hemiparesis. Denied! Hour on phone with insurance company MD. Advised on concerns of falling and afraid they would end up with periprosthetic fracture. Literallyvwas yelling at guy on the phone. Fell on deaf ears. Denied because "doing too well with PT", no alternative but to send home. Patient fell week later in bathroom...periprosthetic fracture....... Readmitted, fixed second fracture..........NOW patient qualifies for acute rehab and can get the help she needed before she had a terrible postop complication......because I guess surgeon judgement is not a match for the judgment of the prior auth overlords. I hate practicing medicine so much, I can't wait to get out. 15 years in.....was burned out at 10.
As a MRI tech at a hospital, i can confirm that this is......painfully accurate 😂😭 Almost all of my outpatients have been waiting several MONTHS for approval for their imaging. So as you can imagine, by the time they actually get to my MRI machine, they're pretty pissed off 😅
Nope it's the femur. But I know you're joking. I just rememberd a *"Nerd explains"* video, where we named a femur "Wilson" and exitedly discussed all possible uses for an acid sharpened femur....and let me tell you this "Wilson" was much more helpful than the ball....to trigger possible traps, stab, smash, block door(-ways) or keep them open, use as a kane and so many other things . And I also would have taken a humerus in case I loose Wilson or have to stabelise a broken bone, make it into a knife for close combat because a femur is hard to hide in your sleeve ( edit:) while crawling through tight spaces and even dive.
@@PureheartFisher Nope, Vienna. And I didn't say knife, I talked about a sharpened femur/ humerus , some of the oldest weapons humans used. Knives etc are totally banned here.
Btw it was : *"How to beat the death tunnel in MEANDER"* - if you want to see Wilson. (And I already know everyone thinks I am lying about my "nice encounter". I only mentioned it, because legally you aren't even allowed to carry a pocket knife if it locks in place once opened. So how is an 80 lbs , 5.1 female supposed to defend herself against possibly more than one person even half their age ? I really don't know. So I sarcasticly thought it would be nice to have a Wilson as it maybe wouldn't count as a weapon.... The police suggested to call 911 but at the time they arrive I don't want to know what a group of up to 3 or more could do, even if they are 14, but trying to impress their girls....) So i'll delete it to spare me more humiliation and " yeah sure that definitively happened". I had enough of it already. ) I don't want to hurt anyone and never have physically, but I am sick of being threated or being hurt.
I did an mri before nasal surgery and I thought it weird I had to leave the specialty clinic complex and drive down the road a couple miles to a strip mall to get it done. It was owned by the clinic but it seriously was behind a gas station.
May have been that the strip mall location was contracted with your insurance and the specialty complex location was not (even though they were owned by the same entity).
Sadly, this is real life! My shoulder was so bad, a year after a bicycle accident, that even when keeping my elbow by my side, I would involuntarily scream just rotating my hand. The doctor ordered an MRI. Even though I did PT for 4 months when the accident first happened, I had to go back to PT. Which just aggravated it more. The physical therapist was annoyed because my shoulder was moving so oddly that she didn't really want to design any program and wanted to know what was actually wrong. Finally, I told my doctor that I was in so much pain, I would just pay for the MRI out of pocket. It turned out that I had a huge tear of the labrum and my bicep tendon was partially torn. My shoulder was also subluxed. Once it popped back into the joint properly, it still felt sore for a few days, but it felt a lot better immediately. Surprise, surprise.
Im no where serious like this but i do need my shoulders checked out and i have no health insurance. So im currently searching for my , well cheapest as bad as that sounds, options. I cant justify paying half my paycheck to health insurance that probably wont cover it anyway... and left with the other half not even able to afford rent. Heck 100% of my paycheck cant even afford rent without a roommate lol!!! My sister is at fault and ngl i have court in my back pocket if she beats me up again. My mom says with what evidence which is true cause i havent seen a doctor for medical proof (and frankly she is "unemployed" so even if i did bring her to court it could probably be dismissed because she "has no way to pay". But i do have a video of her legit beating me up which was the cause of all this nonsense😒 Anyway, somehow i have to suffer the consequences of my nasty sister. Which shouldnt be. Disgusting 😞. True colors show and i want nothing to do with her but im stuck in the same house now with her How much was the mri out of pocket??
It does vary a lot. I had one thirty-two years ago, one thousand dollars cash up-front. Four through the V.A., I am told they cost four hundred dollars each. One cash in-hand about a year ago, four hundred dollars.
As a neuro PT, this is exactly how I get a lot of patients with vague diagnoses like "inractable headaches" and "tremors of the body" with no official medical diagnosis because their insurance company wants them to do PT before getting an MRI, even though everything we try is probably going to fail because we can't see inside the patient's brain 🤦🏻♀️
I literally went through this exact situation last year 😡 My 3 year old has cerebral palsy and I had to jump through every hoop in the book to get an MRI for a diagnosis. I ended up having to wait about 6 months and had to reschedule the thing twice at two different places! All I wanted was to find out what was wrong with my dang kid and insurance made everything impossible.
Those 6 months of deliberately and artificially denying you access to basic Medical treatment was for a good cause though. It made a handful of already wealthy ghouls slightly richer. You and your kid should appreciate that.
Goodness! I'm so sorry for that. She/he could have gotten much needed PT, proper treatment, and a correct diagnosis which is vital for the rest of her life. I'm sure you know that. I can't imagine the anger you have at the system and insurance companies for that to be allowed or even lawful. Like how is this actually not against the law?
I live in Iran and I have done several MRIs for various reasons so far. It costed me something around 10 dollars in public hospitals and up to 20 dollars in the private venues. The maximum waiting time I have ever had to wait for one has been a month (and, it wasn't an emergency). I am not happy about where I live. I am not even happy about the healthcare system. But, I have to acknowledge that it's way better than American or Canadian healthcare. Having lived in the UK for a year, I think when it comes to routine healthcare, it's even better than UK's.
Canada has a perfectly fine health care system, our main problem right now is lack of doctors. If my doctor thinks I need an MRI….I get an MRI, I don’t pay a cent, it’s all done through taxes which I would have to pay regardless.
So when I took anatomy and physiology I took it with billing students. There were so many of them who were legitimately upset they had to go through *any* of this because it didn't apply to them. This is just for hospital billing, but the nightmare is the same when people on the line for insurance have only touched a training pamphlet and nothing else.
My daughter almost died on Christmas morning because our insistence her headaches were more then just growing pains got us medicine that didn't work and told to " monitor and record" her symptoms 3 times over. When we took her in the Er they did xray her brain and admitted her for Hydrocephalus Thing is she never failed the " Nero checks" so short of me going absolutely hit the ceiling crazy on the staff. They were waiting for her to have permanent brain damage and not know who she is, where she was or have control of her limbs. You don't do that to a child. In our pediatricians defense she was on my side and even after Christmas when it was clearly obvious my child was in danger of falling asleep and never waking up we sat there for an extra 90 minutes while she called, consulted, and fought for my kid to have a bed in icu and an mri ...finally
I hope she's ok when I had my first migraine (I didn't know it was a migraine at the time), I went straight to the ER and was in the MRI 15 minutes later and didn't even have to pay for it but then I'm covered under universal healthcare...
Sadly the new truth of our broken healthcare system. They don't want to treat until the damage is already done. Then they say, "oh, if only we caught it sooner". But the truth is they won't catch it sooner because nobody is sick unless their vitals are so dramatically off they're already suffering consequences of long term illness
I was an ophthalmic technician and, although not common, we did need to send patients for MRIs for possible orbital tumors or brain tumors in areas that would effect vision. It was always a nightmare since insurance always said that the patient had to try eye drops or glasses before getting an MRI. This skit hit way to close to home.
Makes me so grateful for my Medicaid with its bare minimum requirements. Everything I’ve had from MRIs to PET scans to brand name medications have been covered except for a copay of $1 for each refill. The prior authorizations couldn’t be more true. I’m still waiting for one to get authorized and it’s been *6 months*
UGH true. I'm all 3; a nurse, working for an insurance carrier, going for an MRI in about 30 mins. This is my 2nd try. Yay I'm getting the help I need!
Oh the accuracy of this hurts a little but it’s also hilarious. I’m a PT and there’s nothing I dislike more than making a patient go through several weeks of torture that will not help just for them to get an MRI approved
My mother in law fell and loss use of her arm which was clearly torn shoulder ligaments. Weeks of PT just ked to her adapting to not using her dominant arm to reach for things, she can't physically put her arms in front of her to brace for a fall, and she lost the stability to drive a car. Pt just made her upset and frustrated and whrn they did do the mri they told us that the "new" dmg was minimal and the older damage was a decade old so thev refused her surgery even though she had multiple full detachments because she could still feed herself and her pt assessment said she had the basic health needed to be in a home with other adults.
I work in primary care, and even getting authorizations for the PT is a pain. we have one insurance that will require "less invasive" therapies like opioids first. then if that doesn't work, you get ONE PT evaluation. if the PT says the patient needs a scan instead, the scan is denied because they haven't done the PT, and the PT is denied because it's "unnecessary." Make this make sense!
@@Yet_AGOTI-2 EXACTLY!!! This isn't a national insurance, but you'd think even local insurances would understand what national guidelines are and why medical professionals should follow them...
As somebody that has spent the past 5 years obtaining authorizations for diagnostic imaging on an outpatient basis I can honestly tell you that this skit has a lot of accuracies. Thankfully the insurance companies that we work with are usually pretty okay with the MRI of the brain (*knock on wood*). All this being said, the patient is going to have to do a crouching crawl walk to get the head imaged. Pretty sure Texaco Mike just put the machine on the ground instead of on the truck bed.
I suffered a cerebrospinal fluid leak, which meant that I could only walk bent double. I did a crouching crawl walk which then helped me get my head imaged 🤣 It took two Dr's visits and three emergency room visits to force my way into the system. I knew my diagnosis and so knew I couldn't just wait around letting then fob me off. Be sure to treat patients with respect, going for imaging is extremely stressful and traumatic so any kindness is greatly appreciated.
@@theseventh5204 I can barely imagine what you were going through, that sounds awful!!! I sincerely hope you're doing better. And i take (and will continue to take) your last sentence to heart, truely. Sending good thoughts your way.
@@riorio982 Thank you so much. I ended up having an epidural blood patch where they inject your own blood into the epidural space in your spine, said blood then some how spreads over the damaged dura plugging the hole and therefore letting your cerebrospinal fluid fully fill up intrathecally and letting your brain float again. I'm feeling alot better and am able to be upright now. Just having another human show concern and compassion when I was going for imaging helped so much. Even saying 'everything is going to be fine, just relax' can really help someone. Such medical issues are life changing and every interaction is remembered. I just know you are great at what you do and your attitude really is a gift for the patients that come into contact with you.
In Australia if the patient needs imaging in the hospital, they get it and don't need to think about money. Seeing how it works in the USA makes me very grateful for my country's system.
This also happens in the US at the VA. There are no prior authorizations unless there is a cardiac pacemaker or other implanted medical device. We are all on salary.
Many Americans buy a gun and shoot themselves when they develop serious health issues because they can't pay for treatment. Well, those are the lucky ones. The unlucky ones wait to shoot themselves _after_ treatment and their families are forced into bankruptcy anyway. Ten years later, one of them develops a serious health issue of their own and the cycle starts all over.
Funny and sad because its 100% TRUE. And this is painfully true for treatments too. I submit requests for prior authorizations on a daily basis. 1st request is always denied (maybe 95-98% of the time). 2nd attempt: I get about 30-40% requests approved by CHANGING ABSOLUTELY NOTHING, literally just resubmitting the same form a second time.
My mom is a nurse for a pulmonary clinic and can confirm this - they just keep resubmitting the same prior auth form and often it's approved on the 2nd or 3rd try even though *nothing* has changed.
I'm really saddened by all the memes and sketches and stuff about your medical system and especially the insurance system. As a French handicapped person with a lot of health issues that needed a ton of exams and surgeries throughout my life, I think I would be dead if I was born in the US instead of where I am. It's insane and I can't believe there's a whole bunch of people who are still against a better system even though they're also not above the middle class and are one heart attack or broken leg away from crushing debt. I hope you guys will one day be able to get something better.
Yes, and it is easy! Enlist in any branch of the military and serve in a war, and you can have "free" (taxpayer-paid, rather than out-of-pocket) medical care and mental health care for life. Or, you can be an illegal immigrant. Or, you can be born in poverty and remain without gainful employment your entire life. Or, you can go to prison. But the healthcare there is literally criminal; a State may budget US$12 per prisoner per year (as an actual instance, Arizona), so it is best to commit a Federal crime. But if you look at our political prisoners, you see Federal prisoners held due to political crimes who are refused the cancer medications their family already bought, medication for psychiatric problems they were prescribed by their own psychiatrist, seizure medication for epilepsy and Parkinson's, prescriptions for heart failure, refusal of dialysis, the list is long . . . for *trespassing.* The military doesn't cover dental -- after your service -- even if you got shot through the jaw and occasionally need new dentures as a result. The others do.
There are soooo many people unwilling to put up money to help anyone else. There are several people in my small town who grumble about taxes that pay for the schools. “I don’t have kids, why should I pay that tax?” Education is important!
Walking out of work one day I suddenly couldn’t feel my legs. CT at ER led to neuro referral. Neuro requested several MRIs. 2 were approved but brain was denied. Neuro’s hands were basically tied so sent to GP who sent to ortho who sent back to neuro. Eventually got the MRI but never received a diagnosis. There have been many other doctors. Lost my job because couldn’t get any of the doctors to fill out my short term disability paperwork. One actually laughed in my face. They either acted like I was making it up to get out of work or gave up on dealing with the insurance. Many tests were delayed or denie. I was weeks away from a promotion with a company I loved. Haven’t been able to work since. This was 5 1/2 years ago. I have very little faith in the healthcare community and less than none for insurance companies. I know there are excellent medical professionals. I’ve met them while taking care of family members. Unfortunately my personal experiences have been horrendous.
Do whatever it takes to get to a large university teaching hospital, or to a facility such as Cleveland Clinic or Mayo Clinic. It is worth every mile you will drive or fly to get the correct diagnosis!!! I am speaking from experience with my spouse. Also, most insurance companies are afraid to refuse tests at these hospitals for fear of lawsuits.
I empathize with you and hear you. I worked as a nurse. I was the one who busted my buns, ran my dept, and crushed any insurance corp bs that came to my desk. I lived by the golden rule. I believed in it. But I got sick. I got a rare form of migraines with auras where aphasia and hemiplegia were a thing. Oh. And reoccurring tumors. Not great working with patients so ... I quit. My medical care? Lazy. Poor notes. Incorrectly submitted paperwork. Prescriptions not being sent. The anger, that if I had done half of this crap, I'd lose my job, was unrelenting. The disrespect to the patients? Unreal. Teach your workers, RNs, secretaries, even doctors training on new EMRs, to take an extra minute or three to do it right the first time so they don't have to keep correcting mistakes. You waste more time and money that way, Corporate America.
@@Cel3ere5 right there with you.39yrs of nursing,now 6yrs disabled c fluctuating weakness, crushing fatigue ,resp decline helped by mestinon. Have had to 'be your own advocate' too often. All just hurts
This is literally the story of how I tried to get an MRI for my knee that had been having issues for over 2 years. I got an approval letter AND a denial letter from my insurance company in the mail on the same day for the MRI after months of pt and an x-ray. It was a very confusing time. Still can't find out what's wrong with my knee.
I’m so glad I live in Australia. Although with all my piercings it would be such a pain to get an MRI I’d rather not to be honest. But since I have a severe chronic disease I am incredibly lucky to live in a country that pays for almost everything I need medically and psychiatrically and psychologically, and private health that almost unquestionably pays for everything else. I’m so sorry you have to go through what you do in the US as a health provider. Love from Oz ❤️
I got a call once from our health insurance wanting me to go to an orthopedic place for an ultrasound of my ovary because I had a large cyst. I was like I don't think they do those kind of ultrasounds and the guy just didn't know what to say when I said that. Then he said well they are much cheaper than the hospital. I will never forget that phone call.
Absolutely on point. There is no way this can get better (the video, I mean, the system probably can). Thank you for sharing your gift with us. Btw, love the microphone / marker. Your costume assistant is doing his homework!
How to get an MRI with socialized/universal health care: - go to a doctor of your choice - get a prescription for an MRI - go to a radiologist of your choice - get the MRI - pay fuck all for it
Yep. The fear of not having essential imaging covered is absolutely nonexistent. Of course, resources are still limited and they might refuse to do an MRI for a backache that doesn't seem serious. But at least both doctors and non-medically trained civil servants are making the decisions for what constitutes cost effective care and what level of quality of life and medical care is acceptable together. And if you happen to be persuasive enough they might just let you have it - and once the doctor says yes, it's covered. The only thing false is going to a radiologist/doctor of your choice - doesn't happen in all systems with universal health care
@@pourint fair enough on the choice... that's how it is for me ;) although I usually go to the radiologist my doctor tells me to, they usually call ahead and get me a slot anyway also, yes, if it's not neccessary I'm not getting into the MRI. probably because the doctors don't gain any profit of sending me to the most expensive diagnostics/therapy
I'm gonna remember this video the next time I see a comment saying America's system is better than the NHS because the waiting times are supposedly shorter
Accurate, especially with medicaid. I had a friend who had vitamin D deficiency and worked retail. It resulted in degenerative disc diseases and she had 2 vertebrae in her lumbar spine that were essentially crumbling. Medicaid made her do PT even though she could barely walk and when she got worse, medicaid made her do steroid injections in the lumbar spine. When that still didn't help, they finally approved her for an MRI. She finally got the proper diagnosis(yes, the vitamin D was dx with bloodwork, not a scan) and was able to get approved for disability because she definitely couldn't stand on her feet for 8hrs a day anymore to work. I didn't have insurance at the time and decided it was in my best interest not to get insurance until I could afford good insurance because she could have been paralyzed following their protocol. When you don't have insurance, they just do what is necessary without the headache of trying other things to get this one thing they wanted at the beginning. Of course, you get the headache of bad credit because MRI is expensive and takes years to pay off out of pocket. I have good insurance now so the only thing they fight me on is the anesthesiologist and Lupron.
We literally had the same conversation with Aetna last month. Needed MRI to R/O meniscus tear (ortho ordered) and they told us to take X-Ray first (obviously didn’t reveal anything) then 6 weeks of PT. 😂 We just paid cash and took the MRI which was $200-300 cheaper than going through insurance. And yes, finding was complete torn meniscus.
The cost variability is nuts. I know my local hospital systems enter into agreements with each other to fix prices, so one system ends up cheaper for X-rays, another is cheaper for CT, etc. Luckily my insurance provider lets us search their negotiated prices for common procedures across all of them and we can find the cheaper options. Anyway, your post reminded me of the price variability, so I looked up at knee MRI w/o contrast. Local hospital system was $1,200. Within 50 miles there was one hospital up to $3,400, but on the other end of the spectrum a big ortho clinic in a nearby city at $330. If I got the MRI done there (or at any of the cheaper locations) my insurance company would also automatically send me a $100 Visa gift card. Anyway, the whole thing is dumb.
This somehow feels fitting- i'm sitting in a holding area waiting for an opening for me to get an diagnostic MRI lol. You're so good at making everything funny!
My job is to do PAs for meds and radiology. For the most part it's repetitive especially if you work in a specialist office like I do. However my biggest obstacle in getting an approval is lack of chart notes and non correlating diagnosis. I can only tell them what is documented and if it doesn't result in an auto approval I will have to fax chart notes, which of course will be lacking. 🙄 That leads to a denial, which leads to a peer to peer - which no Dr seems to want to do and won't - , and that leads to me having to appeal it and or do another PA. 😮💨
Texaco Mike 😂 It took my doctor and I months of calling my insurance company to get my brain mri with and without contrast covered. Thankfully, they finally relented. It was very scary being diagnosed with ocular hypertension at 31 without availability of diagnostic imaging. I work in radiology, which was even more frustrating - I could have walked down the hall and had the scan done. Even worse that we pay around 1,500 a month for insurance. Thank you for bringing light to this subject!
I didn’t think you could possibly ever out due yourself but you just did! Thank you for sharing awareness and how difficult it is to help our sick patients.
I feel this so deep in my bones. In the middle of Long Covid treatment and if anything adds to the weird purgatory of chronic illness it’s trying to get my insurance to consider covering things that might actually help me get better.
I live in Chile, a couple of years ago I took a nasty fall playing basketball and came out with chronic back-pain that seemed to irradiate down to my right leg. My doc thought it was a hernia and ordered an mri, got it with no issue that same day unless I’m misremembering and it only cost a little over the equivalent of 50 usd, honestly the american health system sounds beyond dystopian even as someone living in a “third world country”.
This hits close to home. I just dealt with the joy that is getting worker's comp insurance to approve an MRI. It made dealing with an injury so much more fun.
I had to rewind 3 times to catch what the prior authorizations douchenugget said, because I got so distracted laughing at the Sharpie pretending to be a headset mic. 😂🤣😂🤣 P.S. Doc Glauc, I admire your talent for creating DIY props when Jonathan isn't around. I can tell you tried really hard with this one. 😊
Friend of mine literally broke his back (no paralysis, thank goodness) and the insurance was trying to demand PT before authorizing an MRI. They still don't know exactly what is wrong, and you don't *do* pt for a spine injury like that unless you know it won't cause paralysis. It has been 2 months now.
I think you would do great, turning this into a Netflix, Amazon, or CZcams TV series. I could watch a whole show with these quirky one liners & truth lol.
Meanwhile in Australia, I got an MRI on my neck and my lower back proving I have central stenosis and sciatica. I've been told I need surgery to fix the central stenosis... and it's been 6 months now just waiting to be confirmed onto the surgical waiting list... I have no feeling in three of my fingers on my right hand and they constantly move by themselves... so I've been having *fun*.
I just had an MRI done today at the Veterans hospital. I was supposed to have surgery by an outside provider months ago but VA denied my claim last minute and now I'm starting over. I have a tumor in my neck somewhere around my carotid artery, jugular vein and vegal nerve. I was an incidental finding when treating my uterine and small bowel cancer. Last year...and I get the VA MRI today. I've been waiting for treatment for over a year. So far they have been trying to r/o 1. Thyroid nodule (ruled out by ultrasound) 2. Paraganglioma of carotid body 3. Vagal nerve shawnnoma I have a history of NF1 and cancer...but they will get to it when they can...but they stopped paying my outside Endocrinology oncologist. Now I've been sern for two months by a VA endocrinologist and he is repeating everything that has been done already.
Finally got approved for one and all I had to do was start seeing things pop out of my phone 3D. Had to get my eyes dilated first though to make sure they aren't just being haunted by ghosts
I'm in South Africa and my husband and I are 3 months into a dispute with my medical aid about whether I had cancer or not. I was diagnosed with melanoma that spread to my axillary lymph nodes. I went through two surgeries to remove tumours that were tested by pathologists. Our medical aid fought tooth and nail to deny that I ever had cancer, because then they'd have to pay. To this day they still won't accept that it was cancer.
Most MRI centers will offer a cash price that is usually quite reasonable, often not much more than the deductible. Our cash price is less than the deductible for an MRI scan at the local university medical center. The situation is not ideal, but you can get the scan you need without a lot of spent time and frustration.
I don't know what is worse. This, or polish system, where national fund gives every hospital a hard limit on every test and procedure they can do every year.
There are so so so many amazing things about this skit. Thank you. When I did cardiology I remember these phone calls vividly. I would understand having to call for caths, but when had to call for echocardiograms or other non-invasive tests, it was ridiculous.
I am looking forward to your take on the contrast shortage. Especially when docs are having to order an MRI instead of a CT w/contrast. It shouldn’t be a problem right? MRI’s are not backed up for weeks at all
Basically the US is a place where people live like they had free health insurance but are only really free to die if they don’t have the money to pay the insanely inflated medical costs. Meanwhile they’ve bought CT scanners with taxpayer money to put up in airports because of course that’s more essential than putting them in hospitals
No. This isn't the way things go in most circumstances. Sadly, it depends on the hospital you go to. Edited: I just wanted to add, this is for his brain. Most comments are about knees, shoulders, etc. Brain is put a little higher on the list of importance. Most insurance companies don't care if you fix a joint, PT is way cheaper, and they are hoping somewhere along the way, you get addicted to pills and forget the surgery. It's way cheaper that way.
This is 1000% true! A bean counter with no medical credentials has to give your doctor permission for a necessary procedure. Then you pay a huge copay. I don't see why people say the medical system is broken it makes huge profits for insurance companies. That's the point isn't it?
I’m having flashbacks of my treatment at several VA hospitals. Including one PCP who told me to just put a warm compresses on my severe abdominal pain and take Motrin. Turned out I had large ovarian cysts and had a full hysterectomy outside the VA a few weeks later. Thank God for good Doctors! The OBGYN who saw me was blown away by the VA and made sure to write it up in such a way that it was authorized immediately!
Imagine a world where you didn't have to pay for imaging (or other facets of healthcare) as long as it is indicated... oh wait, that's every other western country in the world. Keep the good videos coming Dr G
I had to get an MRI done my ankle after a severe sprain refused to heal. Went through basically this exact process trying to get it approved, only I could barely walk and got sent across town for a 6 am MRI
Congrats on finishing chemo! Where do you live? A brain tumor is one of the potential causes for the symptoms I'm experiencing, and my specialist ordered an MRI. And my insurance company - who I pay money to "cover" me - just denied the prior authorization that my specialist sent over. Woohoo, great job, America. So tomorrow I get to call the doctor's office and figure out how we appeal. A great use of her time and mine. I bet she doesn't have any other patients to treat! The good thing: I hear that the appeals usually succeed. But I can't exhale until I know. (Oh, and authorized doesn't mean the insurance company pays for all of the MRI cost. Most people still have to pay anywhere from $50, if they're lucky, up to thousands of dollars. That depends on their insurance plan and local provider costs.) I'm not trying to one-up you or anything. If I have a tumor, it's probably benign. It's not likely I will need chemo. So your condition sounds scarier than mine! But my mom has survived brain cancer twice... so I can't rest until I know what's going on and how to tackle it. Not that it should matter, but I'm 36 and an educated, fully-employed homeowner. And even with these advantages, I'm still facing this. It's even worse for many Americans. It breaks my heart. I hope you're feeling well! Brain tumors suck.
@whateverlolawants I'm from the UK, the NHS have been under a lot of stress lately but the care I got was incredible. and don't worry you're totally valid!! My tumor was also benign but was growing enough to need treatment. It is inside of my optic nerve so I couldn't have surgery without likely losing my sight. Chemo didn't make it go away completely but it is smaller and stable now!! I wish you the best of luck with your health, I can't imagine how much unnecessary stress having to fight insurance companies adds, but you got this!
Real things that happen when you try to get an MRI covered by insurance:
- Recommend useless alternative forms of imaging
- Delay approval with things like mandatory physical therapy
- Force the patient to drive an hour or more to a facility that they choose
- Load up Texaco Mike’s schedule until he has nobody available to work the Texaco
You get authorised for an MRI , lay down the patient & run out of the building!😂😅 Radiologists thousand miles away from the scanning room!
God, please no.
Oh I know it's true.
My Best Friend has mild stenois in her neck. This hurts her shoulder & sometimes her wrist.
She did get an MRI.
Now the insurance is paying for PT which isnt helping
You hit the nail on the head every single time! 😆😆😆😆
Doctors and nurses should run all healthcare clinics, plans, insurance. And. Only. Them.
Ugh so true and happens very week in our clinic! When things take way too long like months, we just tell the patient to go to the ED because "it's the worst headache of their life," or "paresis got worse." We would let ED know and see/admit right away, it's terrible terrible waste of ED/hospital resources for something that could have been taken care of as outpatient. Ugh...
Haha I got one immediately. And at a hospital. All I had to do was break my neck in two places, my back in seven, and puncture both my lungs. Just got to learn how to game the system like me.
I dont know what I expected in the comment section, but not this. Well played sir. Although on the serious note its good to see you can watch CZcams and type comments after all that.
Well… well done, @O’Ryan ? You win! (Yet, it doesn’t feel like you win, somehow… I can’t figure out why I feel like that! 😜)
u mean like a pro!?
but seriously ,good luck
@@Adki007 thank you. Yeah luckily my spinal cord bent around every break instead of sever. Thanks for the kind words.
Great attitude about it all.
❤
It sounds dystopian until you meet Texaco Mike; he's actually a brilliant conversationalist.
And MRI work? The man can image a pigeon at 150' away.
That is to say, he does image pigeons at 150' away. Turns out you can adjust the strength way up on them-also, he mounted a gun-sight on it.
Needs to be inside the machine, I hear you ask? Oh no. Texaco Mike widened the aperture so much that technically, the whole world is in his MRI (but especially the pigeons).
@@ConstantlyDamaged 🤣
Lmao
you're saying he's a cunning linguist?
@@ConstantlyDamaged btw your comment is getting me through some shit haha thank you
He's actually not even kidding about Texaco Mike, my friend had to get an MRI and asked me for a ride. We show up to an nearly empty parking lot next to some random office building. In the parking lot was some mobile home looking thing. Its legit like 200 square feet and its just an MRI machine, the tech and the computer. Best park is that for all that, he still had to pay part of it out of pocket, even though he was using the outhouse equivalent of an MRI facility. This country is a legit joke
Just because it's in a trailer doesn't mean there isn't a 3T MR scanner with the latest software packages which take awesome pictures. I personally refuse to read the crap 0.5T or 1T "open MRI" images sent from imaging centers with beautiful waiting rooms. Don't judge a book by its cover: let me determine the quality of the imaging. Sincerely, a radiologist
@@yonpark6245 Yep. I used to live in a rural area, and we had an old bus/motor home thing that came around to do mammograms. The images they took were actually better than the closest hospital. Can't always judge a book by its cover.
@@queenbunnyfoofoo6112 no offence, whilst what u r saying is true, for the richest most powerful country in the world its a crying shame.
@@sithembisobuthelezi903 True. However, in Queen BunnyFooFoo’s case she mentions rural area. There are many people in rural areas that if the traveling mammo machine didn’t come to them, they would be unable to get their mammograms done. Lesser of the evils is the trailer, which is far better than stage IV breast cancer as an incidental finding down the road.
@@KB-ct7th Absolutely that van was a lifesaver for many women. My other point is that just because a place has fancy carpets and decorations doesn't mean the care is any better. I now live in a good sized city, and my old provider's company recently built a brand new fancy building to move into. Of course now the company has to pay for that building by jamming as many patients thru as possible every day. My provider was great, but he's now only allowed 10 minutes per patient by corporate.... and that 10 minutes is after I spent an hour in the waiting room. I switched to a doc in private practice. His office is old, yet his revisits are 30 to 40 minutes....longer if you have a problem. The bean counters have totally ruined healthcare.
Texaco Mike needs to be an occasionally recurring character. I'm picturing cutoff scrubs and a greasy bandana.
There's a nurse in our ER who dresses basically exactly like that. He's one of my favorites.
Trucker cap saying "Scan n' Go".
@@windserpent2 I laugh wayyyy to hard at this!
Just don't let Johnathan know . . . . 😉
Im so digging this! Please make it happen
The fact that this skit has to exist is a huge indictment of our countries' medical system. Love your videos.
medical system? i don't think it'd functions well enough medically to qualified for either epitheth. insurance scam is a more honest reflection
*country
I am not aware of any other first-world country where healthcare is as broken as in the US
I just really cannot believe for a country as wealthy as the US that this actually happens and you don’t have Universal Healthcare. I also can’t believe that Americans are seemingly content and happy with the system given that election after election people don’t vote for candidates promising UH and candidates don’t feel the need to stand on the platform of supporting it.
Utterly baffling.
@@GiraffeFeatures I am very unhappy with a LOT of the stuff we do. I try to vote but nothing ever changes. I am so worried for my future and the future of my people but I feel completely powerless to do anything about it. There are too many people that think we're perfectly fine, all that needs to happen is to "pull up your bootstraps", work hard, and become Christian and everything will fix itself.
@@GiraffeFeatures that’s bc the only parties that actively support cheaper healthcare are usually the green or libertarian which are both unpopular
As someone who used to work at an imaging clinic, this is straight up facts. Will never forget when a patient with a history of cancer was denied for an MRI despite their doctor wanting to do a routine check. Apparently insurance companies would rather you start suffering first than catch it early and prevent it getting worse. 😐
Moneyy
They make/save more money that way. -_-
When I was booking appts for MRIs sadly the ones with cancer us usually have to wait months before they can get one and this is in Canada free healthcare. The ones who required MRIs for their joints like knees, elbows, ankles etc usually get theirs right away and the patients don’t appreciate nor care. Most would no show. They’re not paying out of pocket and they don’t have to pay a no show fee so they tend to take advantage
No insurance companies would rather the sick patients die quickly so they don't need to pay anything for necessary preventative treatments. Had this issue with BF getting insulin for his diabetes. US and doc fought for 5 months with the insurance company. Snuck the meds over from Canada paying out of pocket, but hey it was $500 cheaper there than in the US. Insurance randomly approved things after 5 months, apparently this is common to weed people out. Then only the ones who are still persistent after that time are approved. All I could think when I learned this was "weed out"? You mean die?! Bc that's what not having insulin will do when you're diabetic.
Although later stages of the treatment will eventually cost the insurance companies more. They're dumb
“The patient just walks briskly by the MRI machine and Mike gets whatever images he can” amazing
As a radiologist, I love to get these kinds of images to analyze. So full of useful data XD
@@sophiathore3538 reminds me of my surgery professor. *points at fuzzy barely perceptible radiolucency* “ah yes, osteosarcoma” my brother in Christ, that is a cotton ball
The patient has hemiparesis too 😂
@@jent5573 lmao
@@LedHabel”my brother in Christ, that is a cotton ball” cracked me up way more than it should’ve lmfao
This came at the perfect time. My dad’s been trying to get an MRI for years, gone to so many hospitals, but they never did it. Long waiting list, and expensive too. Recently he basically lost power in his legs so we took him to the hospital in a wheelchair. They admitted him in for a week and then did the MRI. That’s “all” it took.
what is the diagnosis? medical student here
Really sorry to hear about your Father, I hope he’s doing ok?
Conversely as a European when my Father suffered from Transverse Myelitis and had to learn how to walk again, he was in hospital for 4 months completely free of charge, given Physio and OT and was in a specialised rehabilitation ward with specialised Nurses etc. Lost count the amount of CT and MRI scans he received, and x-rays.
Our only complaint and his too was that he didn’t get as much Physio as he would have liked/needed so as a personal choice he picked up extra physio at his own expense but in comparison to your situation that seems unimportant!
I feel extremely lucky that we have the system we have when I read stories like this!
Insurance requires you to go through an X-ray and then a CT before an MRI to save money, even though an MRI would save more money in the long run.
@@medgabriel its not out yet, this was very recent. they just did the scan and let him go home, who knows when they’ll get back to us.
I'm also here for diagnosis as a med student.
Extremely accurate.
As part of my follow-up care for this cancer I had, I required PET scans. & the guidelines were clear that annual pet scans were warranted... The insurance said, "nah you good bro". They didn't approve it. Sooo they're really out here practicing medicine trying to determine what I should and should not get. It's actually insane.
Very thankful for living in Sweden! Fell of a horse, banged my head, a bit of a headache, went to the ER, saw a nurse, saw a doctor, was given an MRI upstairs, saw the doctor again, paid 70$. No insurance company involved, the doctor just got me the care he saw fit. Yes we pay quite high taxes but, when you get sick you can always get the right care no matter your income or insurance.
I hope someday America will be like Sweden. I saw a CZcams video a remote viewer said we would be like Sweden in about 2050 do to sea levels rising and climate change. I'll be dead by then but I hope we really do get it America system sucks and it could be changed they think it can't be but it can be it will have to be also housing needs to be changed. I'm 66 and living in a motel by the freeway I'm homeless. I believe dr. Robert schoch and Edgar Cayce.
Our system is so shity. I went to the county for destitute people to get some blood pressure medicine and the doctor wouldn't give it to me. I begged her for it because I said I won't even be able to get here again there's no public transportation in the suburbs of Houston I had no friends and no good family. I went without blood pressure medicine for two years and it enlarged my heart and now I have congestive heart failure for no other reason than I couldn't get simple cheap blood pressure medicine. Now I'm homeless because I can't get subsidized housing.
You want to know something else that makes me mad I lived in a UFO hotspot in 1969 in Roseville California I saw anti-gravity aircraft every night for four years while I lived in that house. Not just me. America does have a secret space program and they put billions of dollars into it that's why they don't have money for their people. I kid you not my ex is a psychologist ex fiance his best buddy moved out to where I used to live then called him long distance after a few years and said I'm seeing UFOs out here. And my ex said that's what Kay said over 50 years ago. I'm just saying I know we've got the zero point energy I know it but only the shadow government the black government has it the real government doesn't have control of it that I know we have it and we should be spending it on the people of America. Not secret space programs.
Americans will never accept funding a system like Swedes via taxes. The word taxes is is more offensive than the n word in American culture.
Keep up your Swedish value system: "We all do better when we all do better."
High taxes for basic human rights that are the point of society is socialism dontcha know
How is there no class action lawsuit led by every doctor in the US suing the insurance companies over practicing medicine without a medial license? This is madness!
Totally agree! I am Canadian and went down their as a nurse and the bull shit nonsense people were spewing about how bad socialized healthcare is was ridiculous! Totally indoctrinated by false information that was fed to them by capitalist assholes wanting to continue to profit from healthcare. It’s actually so sickening to me! Don’t even get me started on the fact they only have 12 week maternity leave - I was off paid for 14 months!
Because money runs this world
Because we, the people, have forgotten how to effectively voice our displeasure with the status quo.
Because cash is king and in any battle with money in the US, money will win
Technically speaking the guidelines for insurance are created by insurance-employed doctors. Then it's up to some sort of clinician (I dont know level of education) to determine if your request meets said guidelines. So it's less practicing medicine and more auditing someone else's medicine. At least that was how it was done 5 years ago before I switched employment from a top 5 insurance to work for the enemy (a hospital position that is the exact opposite of my previous position).
As a UK medic, prior authorisations make no sense to me! Like, we ONLY do scans etc if it's genuinely medically necessary and the best option. The fact that a non-medical person who doesn't know the patient, hasn't clinically examined them, and can just reject a necessary scan simply based on monetary value is just incomprehensible to me?????
It’s incomprehensible to anyone with a functioning brain.
It’s incomprehensible to anyone with a functioning brain.
Welcome to America baby, land of the free if you can afford it
Ahhh US health insurance.
You forgot the person who says no?
Probably has no medical training what so ever
@@dr.floridamanphd Even for the patient who hasn't a fully functional brain.....
This is so true! As a physician I hate these prior authorization conversations. It’s such a waste of my time and I feel the insurance company is making stuff up. Thank you for this funny but so true video. We need the public to know how broken the system is. Sincerely, one burned out physician
I hate that its all about greed and money in the end, humanity goes down hill. Like we could all improve our life quality if we are kinder to each other but the "psychopaths" and "narcissists" are ruining it for all (selfish power hungry people etc).
Anyone that’s had a medical issue knows it’s broken. And we the patients suffer.
I’m 1000% with you
@@mrsbluesky8415 It's not broken it's designed this way.
Same. My most recent prior Auth denial was acute rehab admission for a patient after hip hemiarthroplasty with history of CVA and hemiparesis. Denied! Hour on phone with insurance company MD. Advised on concerns of falling and afraid they would end up with periprosthetic fracture. Literallyvwas yelling at guy on the phone. Fell on deaf ears. Denied because "doing too well with PT", no alternative but to send home. Patient fell week later in bathroom...periprosthetic fracture.......
Readmitted, fixed second fracture..........NOW patient qualifies for acute rehab and can get the help she needed before she had a terrible postop complication......because I guess surgeon judgement is not a match for the judgment of the prior auth overlords. I hate practicing medicine so much, I can't wait to get out. 15 years in.....was burned out at 10.
As a MRI tech at a hospital, i can confirm that this is......painfully accurate 😂😭 Almost all of my outpatients have been waiting several MONTHS for approval for their imaging. So as you can imagine, by the time they actually get to my MRI machine, they're pretty pissed off 😅
In Canada, the scans are immediately approved, just gotta wait several months for an appointment 🙄
Lmao so true! Got Ortho excited for nothing! According to UHC the brain is the strongest bone in the body! This was 100% confirmed by Texico Mike. .
Nope it's the femur.
But I know you're joking.
I just rememberd a *"Nerd explains"* video, where we named a femur "Wilson" and exitedly discussed all possible uses for an acid sharpened femur....and let me tell you this "Wilson" was much more helpful than the ball....to trigger possible traps, stab, smash, block door(-ways) or keep them open, use as a kane and so many other things . And I also would have taken a humerus in case I loose Wilson or have to stabelise a broken bone, make it into a knife for close combat because a femur is hard to hide in your sleeve ( edit:) while crawling through tight spaces and even dive.
🤣🤣
@@janedoex1398 wait a minute
knife, sleeve?
guys I found the average londoner in the chat
@@PureheartFisher
Nope, Vienna. And I didn't say knife, I talked about a sharpened femur/ humerus , some of the oldest weapons humans used.
Knives etc are totally banned here.
Btw it was : *"How to beat the death tunnel in MEANDER"* - if you want to see Wilson.
(And I already know everyone thinks I am lying about my "nice encounter".
I only mentioned it, because legally you aren't even allowed to carry a pocket knife if it locks in place once opened. So how is an 80 lbs , 5.1 female supposed to defend herself against possibly more than one person even half their age ?
I really don't know.
So I sarcasticly thought it would be nice to have a Wilson as it maybe wouldn't count as a weapon....
The police suggested to call 911 but at the time they arrive I don't want to know what a group of up to 3 or more could do, even if they are 14, but trying to impress their girls....)
So i'll delete it to spare me more humiliation and " yeah sure that definitively happened".
I had enough of it already. )
I don't want to hurt anyone and never have physically, but I am sick of being threated or being hurt.
I did an mri before nasal surgery and I thought it weird I had to leave the specialty clinic complex and drive down the road a couple miles to a strip mall to get it done. It was owned by the clinic but it seriously was behind a gas station.
You forgot to tell it was done by Texaco Mike
May have been that the strip mall location was contracted with your insurance and the specialty complex location was not (even though they were owned by the same entity).
Sadly, this is real life! My shoulder was so bad, a year after a bicycle accident, that even when keeping my elbow by my side, I would involuntarily scream just rotating my hand. The doctor ordered an MRI. Even though I did PT for 4 months when the accident first happened, I had to go back to PT. Which just aggravated it more. The physical therapist was annoyed because my shoulder was moving so oddly that she didn't really want to design any program and wanted to know what was actually wrong. Finally, I told my doctor that I was in so much pain, I would just pay for the MRI out of pocket. It turned out that I had a huge tear of the labrum and my bicep tendon was partially torn. My shoulder was also subluxed. Once it popped back into the joint properly, it still felt sore for a few days, but it felt a lot better immediately. Surprise, surprise.
Im no where serious like this but i do need my shoulders checked out and i have no health insurance. So im currently searching for my , well cheapest as bad as that sounds, options. I cant justify paying half my paycheck to health insurance that probably wont cover it anyway... and left with the other half not even able to afford rent. Heck 100% of my paycheck cant even afford rent without a roommate lol!!!
My sister is at fault and ngl i have court in my back pocket if she beats me up again. My mom says with what evidence which is true cause i havent seen a doctor for medical proof (and frankly she is "unemployed" so even if i did bring her to court it could probably be dismissed because she "has no way to pay". But i do have a video of her legit beating me up which was the cause of all this nonsense😒
Anyway, somehow i have to suffer the consequences of my nasty sister. Which shouldnt be. Disgusting 😞. True colors show and i want nothing to do with her but im stuck in the same house now with her
How much was the mri out of pocket??
@@aufache It was about $2,500. I think it varies where you live but a few thousand is normal.
It does vary a lot. I had one thirty-two years ago, one thousand dollars cash up-front. Four through the V.A., I am told they cost four hundred dollars each. One cash in-hand about a year ago, four hundred dollars.
As a neuro PT, this is exactly how I get a lot of patients with vague diagnoses like "inractable headaches" and "tremors of the body" with no official medical diagnosis because their insurance company wants them to do PT before getting an MRI, even though everything we try is probably going to fail because we can't see inside the patient's brain 🤦🏻♀️
I need one and still can’t get it
I literally went through this exact situation last year 😡 My 3 year old has cerebral palsy and I had to jump through every hoop in the book to get an MRI for a diagnosis. I ended up having to wait about 6 months and had to reschedule the thing twice at two different places! All I wanted was to find out what was wrong with my dang kid and insurance made everything impossible.
Those 6 months of deliberately and artificially denying you access to basic Medical treatment was for a good cause though.
It made a handful of already wealthy ghouls slightly richer. You and your kid should appreciate that.
Goodness! I'm so sorry for that. She/he could have gotten much needed PT, proper treatment, and a correct diagnosis which is vital for the rest of her life. I'm sure you know that. I can't imagine the anger you have at the system and insurance companies for that to be allowed or even lawful. Like how is this actually not against the law?
You forgot the last thing they always say. "This is no guarantee of payment."
I live in Iran and I have done several MRIs for various reasons so far. It costed me something around 10 dollars in public hospitals and up to 20 dollars in the private venues. The maximum waiting time I have ever had to wait for one has been a month (and, it wasn't an emergency). I am not happy about where I live. I am not even happy about the healthcare system. But, I have to acknowledge that it's way better than American or Canadian healthcare. Having lived in the UK for a year, I think when it comes to routine healthcare, it's even better than UK's.
Canada has a perfectly fine health care system, our main problem right now is lack of doctors. If my doctor thinks I need an MRI….I get an MRI, I don’t pay a cent, it’s all done through taxes which I would have to pay regardless.
I'm endlessly impressed that you can somehow turn a horror show like insurance into a comedy sketch.
So when I took anatomy and physiology I took it with billing students. There were so many of them who were legitimately upset they had to go through *any* of this because it didn't apply to them. This is just for hospital billing, but the nightmare is the same when people on the line for insurance have only touched a training pamphlet and nothing else.
My daughter almost died on Christmas morning because our insistence her headaches were more then just growing pains got us medicine that didn't work and told to " monitor and record" her symptoms 3 times over.
When we took her in the Er they did xray her brain and admitted her for Hydrocephalus
Thing is she never failed the " Nero checks" so short of me going absolutely hit the ceiling crazy on the staff. They were waiting for her to have permanent brain damage and not know who she is, where she was or have control of her limbs.
You don't do that to a child.
In our pediatricians defense she was on my side and even after Christmas when it was clearly obvious my child was in danger of falling asleep and never waking up we sat there for an extra 90 minutes while she called, consulted, and fought for my kid to have a bed in icu and an mri ...finally
That is do sad, hopefully she is okay now
I hope she's ok
when I had my first migraine (I didn't know it was a migraine at the time), I went straight to the ER and was in the MRI 15 minutes later and didn't even have to pay for it
but then I'm covered under universal healthcare...
That's terrible. Hope your daughter is all right
Sadly the new truth of our broken healthcare system. They don't want to treat until the damage is already done. Then they say, "oh, if only we caught it sooner". But the truth is they won't catch it sooner because nobody is sick unless their vitals are so dramatically off they're already suffering consequences of long term illness
As a brain cancer patient needing MRIs every 3-6 months this one hits home. So sad but true
I was an ophthalmic technician and, although not common, we did need to send patients for MRIs for possible orbital tumors or brain tumors in areas that would effect vision.
It was always a nightmare since insurance always said that the patient had to try eye drops or glasses before getting an MRI. This skit hit way to close to home.
“My patient needs an MRI.”
“We can’t just give away Teslas!”
3 Teslas!!!
😆 LOL!
Loved the part about the how to practice medicine manual the insurance clerk has
Makes me so grateful for my Medicaid with its bare minimum requirements. Everything I’ve had from MRIs to PET scans to brand name medications have been covered except for a copay of $1 for each refill. The prior authorizations couldn’t be more true. I’m still waiting for one to get authorized and it’s been *6 months*
I have a progressive Brain Condition 🤕💔🥺 finally had an MRI a cpl months ago..
This is PAINFULLY 99.9% Acurate...
Ty dr. G for your work...
UGH true. I'm all 3; a nurse, working for an insurance carrier, going for an MRI in about 30 mins. This is my 2nd try. Yay I'm getting the help I need!
Wishing you good quality images leading to a helpful diagnosis!
You can do it!!! I always have to take medication myself - and I’ve worked with our MRI team…
Oh the accuracy of this hurts a little but it’s also hilarious. I’m a PT and there’s nothing I dislike more than making a patient go through several weeks of torture that will not help just for them to get an MRI approved
My mother in law fell and loss use of her arm which was clearly torn shoulder ligaments.
Weeks of PT just ked to her adapting to not using her dominant arm to reach for things, she can't physically put her arms in front of her to brace for a fall, and she lost the stability to drive a car.
Pt just made her upset and frustrated and whrn they did do the mri they told us that the "new" dmg was minimal and the older damage was a decade old so thev refused her surgery even though she had multiple full detachments because she could still feed herself and her pt assessment said she had the basic health needed to be in a home with other adults.
I work in primary care, and even getting authorizations for the PT is a pain. we have one insurance that will require "less invasive" therapies like opioids first. then if that doesn't work, you get ONE PT evaluation. if the PT says the patient needs a scan instead, the scan is denied because they haven't done the PT, and the PT is denied because it's "unnecessary." Make this make sense!
@@socialdeviant13 REQUIRING OPIATES FIRST? WITH AN OPIOID EPIDEMIC?!
WHAT?!
@@Yet_AGOTI-2 EXACTLY!!! This isn't a national insurance, but you'd think even local insurances would understand what national guidelines are and why medical professionals should follow them...
@@Yet_AGOTI-2 Yep. Been there, done that, finally got the MRI 2 years after my dr. refused to do it 'their way anymore.
As somebody that has spent the past 5 years obtaining authorizations for diagnostic imaging on an outpatient basis I can honestly tell you that this skit has a lot of accuracies. Thankfully the insurance companies that we work with are usually pretty okay with the MRI of the brain (*knock on wood*). All this being said, the patient is going to have to do a crouching crawl walk to get the head imaged. Pretty sure Texaco Mike just put the machine on the ground instead of on the truck bed.
I suffered a cerebrospinal fluid leak, which meant that I could only walk bent double. I did a crouching crawl walk which then helped me get my head imaged 🤣
It took two Dr's visits and three emergency room visits to force my way into the system. I knew my diagnosis and so knew I couldn't just wait around letting then fob me off. Be sure to treat patients with respect, going for imaging is extremely stressful and traumatic so any kindness is greatly appreciated.
@@theseventh5204 I can barely imagine what you were going through, that sounds awful!!! I sincerely hope you're doing better. And i take (and will continue to take) your last sentence to heart, truely. Sending good thoughts your way.
@@riorio982 Thank you so much. I ended up having an epidural blood patch where they inject your own blood into the epidural space in your spine, said blood then some how spreads over the damaged dura plugging the hole and therefore letting your cerebrospinal fluid fully fill up intrathecally and letting your brain float again. I'm feeling alot better and am able to be upright now. Just having another human show concern and compassion when I was going for imaging helped so much. Even saying 'everything is going to be fine, just relax' can really help someone. Such medical issues are life changing and every interaction is remembered. I just know you are great at what you do and your attitude really is a gift for the patients that come into contact with you.
In Australia if the patient needs imaging in the hospital, they get it and don't need to think about money. Seeing how it works in the USA makes me very grateful for my country's system.
Why the hell does anybody even bother becoming a doctor in America?
@@allgreatfictions Because America pays doctors better than any other country in the world
This also happens in the US at the VA. There are no prior authorizations unless there is a cardiac pacemaker or other implanted medical device. We are all on salary.
@@Zer0r2 laughs in medical school bills
...and your story makes me wonder about moving to Australia!
I’m glad I live in Canada. I can’t imagine dealing with that nonsense.
You're so lucky!
Many Americans buy a gun and shoot themselves when they develop serious health issues because they can't pay for treatment.
Well, those are the lucky ones. The unlucky ones wait to shoot themselves _after_ treatment and their families are forced into bankruptcy anyway. Ten years later, one of them develops a serious health issue of their own and the cycle starts all over.
Funny and sad because its 100% TRUE. And this is painfully true for treatments too. I submit requests for prior authorizations on a daily basis. 1st request is always denied (maybe 95-98% of the time). 2nd attempt: I get about 30-40% requests approved by CHANGING ABSOLUTELY NOTHING, literally just resubmitting the same form a second time.
My mom is a nurse for a pulmonary clinic and can confirm this - they just keep resubmitting the same prior auth form and often it's approved on the 2nd or 3rd try even though *nothing* has changed.
I'm really saddened by all the memes and sketches and stuff about your medical system and especially the insurance system. As a French handicapped person with a lot of health issues that needed a ton of exams and surgeries throughout my life, I think I would be dead if I was born in the US instead of where I am. It's insane and I can't believe there's a whole bunch of people who are still against a better system even though they're also not above the middle class and are one heart attack or broken leg away from crushing debt. I hope you guys will one day be able to get something better.
Thank you! Living in the US my entire life, I've realized that at least half of the country's citizens have no brain.
Yes, and it is easy!
Enlist in any branch of the military and serve in a war, and you can have "free" (taxpayer-paid, rather than out-of-pocket) medical care and mental health care for life.
Or, you can be an illegal immigrant.
Or, you can be born in poverty and remain without gainful employment your entire life.
Or, you can go to prison. But the healthcare there is literally criminal; a State may budget US$12 per prisoner per year (as an actual instance, Arizona), so it is best to commit a Federal crime. But if you look at our political prisoners, you see Federal prisoners held due to political crimes who are refused the cancer medications their family already bought, medication for psychiatric problems they were prescribed by their own psychiatrist, seizure medication for epilepsy and Parkinson's, prescriptions for heart failure, refusal of dialysis, the list is long . . . for *trespassing.*
The military doesn't cover dental -- after your service -- even if you got shot through the jaw and occasionally need new dentures as a result. The others do.
There are soooo many people unwilling to put up money to help anyone else. There are several people in my small town who grumble about taxes that pay for the schools. “I don’t have kids, why should I pay that tax?” Education is important!
Walking out of work one day I suddenly couldn’t feel my legs. CT at ER led to neuro referral. Neuro requested several MRIs. 2 were approved but brain was denied. Neuro’s hands were basically tied so sent to GP who sent to ortho who sent back to neuro. Eventually got the MRI but never received a diagnosis. There have been many other doctors. Lost my job because couldn’t get any of the doctors to fill out my short term disability paperwork. One actually laughed in my face. They either acted like I was making it up to get out of work or gave up on dealing with the insurance. Many tests were delayed or denie. I was weeks away from a promotion with a company I loved. Haven’t been able to work since. This was 5 1/2 years ago. I have very little faith in the healthcare community and less than none for insurance companies. I know there are excellent medical professionals. I’ve met them while taking care of family members. Unfortunately my personal experiences have been horrendous.
I was so sorry to read this - I hope that you will get a resolution very soon. Outrageously unfair and awful treatment. All the best.
So sorry to hear this! I wish you the very best in the future!
Do whatever it takes to get to a large university teaching hospital, or to a facility such as Cleveland Clinic or Mayo Clinic. It is worth every mile you will drive or fly to get the correct diagnosis!!! I am speaking from experience with my spouse. Also, most insurance companies are afraid to refuse tests at these hospitals for fear of lawsuits.
I empathize with you and hear you. I worked as a nurse. I was the one who busted my buns, ran my dept, and crushed any insurance corp bs that came to my desk. I lived by the golden rule. I believed in it. But I got sick. I got a rare form of migraines with auras where aphasia and hemiplegia were a thing. Oh. And reoccurring tumors. Not great working with patients so ... I quit. My medical care? Lazy. Poor notes. Incorrectly submitted paperwork. Prescriptions not being sent. The anger, that if I had done half of this crap, I'd lose my job, was unrelenting. The disrespect to the patients? Unreal. Teach your workers, RNs, secretaries, even doctors training on new EMRs, to take an extra minute or three to do it right the first time so they don't have to keep correcting mistakes. You waste more time and money that way, Corporate America.
@@Cel3ere5 right there with you.39yrs of nursing,now 6yrs disabled c fluctuating weakness, crushing fatigue ,resp decline helped by mestinon. Have had to 'be your own advocate' too often. All just hurts
Ortho bro waking up briefly made my day.
This is literally the story of how I tried to get an MRI for my knee that had been having issues for over 2 years. I got an approval letter AND a denial letter from my insurance company in the mail on the same day for the MRI after months of pt and an x-ray. It was a very confusing time. Still can't find out what's wrong with my knee.
Come to Europe, much easier
Every time I learn something new about US healthcare I'm more convinced that's a dystopian country.
It absolutely is. Source: lived here 36 years.
I’m so glad I live in Australia. Although with all my piercings it would be such a pain to get an MRI I’d rather not to be honest. But since I have a severe chronic disease I am incredibly lucky to live in a country that pays for almost everything I need medically and psychiatrically and psychologically, and private health that almost unquestionably pays for everything else. I’m so sorry you have to go through what you do in the US as a health provider. Love from Oz ❤️
I feel the same about that here in Canada. Our health care system isn't perfect but so glad we don't have to worry about this!
In Canada, we don't have to worry about being approved. We just have long wait times.
You pay for it. It's called "taxes". Where do you think the government gets its money? From it's unicorn ranch?
@@henrysmith180 REALLY long wait times. And not enough funding to hire every new doctor. Guess where they go to find jobs?
As someone not from the US, this sounds like a horrific dystopia
I'm from the US, and it is a horrific dystopia
I got a call once from our health insurance wanting me to go to an orthopedic place for an ultrasound of my ovary because I had a large cyst. I was like I don't think they do those kind of ultrasounds and the guy just didn't know what to say when I said that. Then he said well they are much cheaper than the hospital. I will never forget that phone call.
Absolutely on point. There is no way this can get better (the video, I mean, the system probably can). Thank you for sharing your gift with us. Btw, love the microphone / marker. Your costume assistant is doing his homework!
How to get an MRI with socialized/universal health care:
- go to a doctor of your choice
- get a prescription for an MRI
- go to a radiologist of your choice
- get the MRI
- pay fuck all for it
Yep. The fear of not having essential imaging covered is absolutely nonexistent. Of course, resources are still limited and they might refuse to do an MRI for a backache that doesn't seem serious. But at least both doctors and non-medically trained civil servants are making the decisions for what constitutes cost effective care and what level of quality of life and medical care is acceptable together. And if you happen to be persuasive enough they might just let you have it - and once the doctor says yes, it's covered.
The only thing false is going to a radiologist/doctor of your choice - doesn't happen in all systems with universal health care
@@pourint fair enough on the choice... that's how it is for me ;) although I usually go to the radiologist my doctor tells me to, they usually call ahead and get me a slot anyway
also, yes, if it's not neccessary I'm not getting into the MRI.
probably because the doctors don't gain any profit of sending me to the most expensive diagnostics/therapy
I'm gonna remember this video the next time I see a comment saying America's system is better than the NHS because the waiting times are supposedly shorter
Accurate, especially with medicaid. I had a friend who had vitamin D deficiency and worked retail. It resulted in degenerative disc diseases and she had 2 vertebrae in her lumbar spine that were essentially crumbling. Medicaid made her do PT even though she could barely walk and when she got worse, medicaid made her do steroid injections in the lumbar spine. When that still didn't help, they finally approved her for an MRI. She finally got the proper diagnosis(yes, the vitamin D was dx with bloodwork, not a scan) and was able to get approved for disability because she definitely couldn't stand on her feet for 8hrs a day anymore to work. I didn't have insurance at the time and decided it was in my best interest not to get insurance until I could afford good insurance because she could have been paralyzed following their protocol. When you don't have insurance, they just do what is necessary without the headache of trying other things to get this one thing they wanted at the beginning. Of course, you get the headache of bad credit because MRI is expensive and takes years to pay off out of pocket. I have good insurance now so the only thing they fight me on is the anesthesiologist and Lupron.
We literally had the same conversation with Aetna last month. Needed MRI to R/O meniscus tear (ortho ordered) and they told us to take X-Ray first (obviously didn’t reveal anything) then 6 weeks of PT. 😂 We just paid cash and took the MRI which was $200-300 cheaper than going through insurance. And yes, finding was complete torn meniscus.
The cost variability is nuts. I know my local hospital systems enter into agreements with each other to fix prices, so one system ends up cheaper for X-rays, another is cheaper for CT, etc. Luckily my insurance provider lets us search their negotiated prices for common procedures across all of them and we can find the cheaper options.
Anyway, your post reminded me of the price variability, so I looked up at knee MRI w/o contrast. Local hospital system was $1,200. Within 50 miles there was one hospital up to $3,400, but on the other end of the spectrum a big ortho clinic in a nearby city at $330. If I got the MRI done there (or at any of the cheaper locations) my insurance company would also automatically send me a $100 Visa gift card. Anyway, the whole thing is dumb.
This somehow feels fitting- i'm sitting in a holding area waiting for an opening for me to get an diagnostic MRI lol. You're so good at making everything funny!
My job is to do PAs for meds and radiology. For the most part it's repetitive especially if you work in a specialist office like I do. However my biggest obstacle in getting an approval is lack of chart notes and non correlating diagnosis. I can only tell them what is documented and if it doesn't result in an auto approval I will have to fax chart notes, which of course will be lacking. 🙄 That leads to a denial, which leads to a peer to peer - which no Dr seems to want to do and won't - , and that leads to me having to appeal it and or do another PA. 😮💨
Texaco Mike 😂
It took my doctor and I months of calling my insurance company to get my brain mri with and without contrast covered. Thankfully, they finally relented. It was very scary being diagnosed with ocular hypertension at 31 without availability of diagnostic imaging. I work in radiology, which was even more frustrating - I could have walked down the hall and had the scan done. Even worse that we pay around 1,500 a month for insurance. Thank you for bringing light to this subject!
I didn’t think you could possibly ever out due yourself but you just did! Thank you for sharing awareness and how difficult it is to help our sick patients.
I feel this so deep in my bones. In the middle of Long Covid treatment and if anything adds to the weird purgatory of chronic illness it’s trying to get my insurance to consider covering things that might actually help me get better.
BONES!?!!?
@@hiltonian_1260 … and Ortho descends from the ceiling Mission Impossible style 😂
@@ksiberine But seriously, sorry to hear about all the hassle. Insurance companies are the worst.
I live in Chile, a couple of years ago I took a nasty fall playing basketball and came out with chronic back-pain that seemed to irradiate down to my right leg. My doc thought it was a hernia and ordered an mri, got it with no issue that same day unless I’m misremembering and it only cost a little over the equivalent of 50 usd, honestly the american health system sounds beyond dystopian even as someone living in a “third world country”.
This is spot on. You just left out the endless automated circular phone system.
This hits close to home. I just dealt with the joy that is getting worker's comp insurance to approve an MRI. It made dealing with an injury so much more fun.
Literally going through this right now as a patient. Gave me a good chuckle! Appreciate it! Love your humor!
I had to rewind 3 times to catch what the prior authorizations douchenugget said, because I got so distracted laughing at the Sharpie pretending to be a headset mic. 😂🤣😂🤣
P.S. Doc Glauc, I admire your talent for creating DIY props when Jonathan isn't around. I can tell you tried really hard with this one. 😊
Same. I just kept watching the Sharpie flip back and forth. It was hypnotic. Like a lava lamp.
@@egonmilanowski Lol.
Douche Nugget. 😂😂😂
Friend of mine literally broke his back (no paralysis, thank goodness) and the insurance was trying to demand PT before authorizing an MRI. They still don't know exactly what is wrong, and you don't *do* pt for a spine injury like that unless you know it won't cause paralysis. It has been 2 months now.
When its so accurate you couldn't laugh. The anger within refuses to allow you to.
I think you would do great, turning this into a Netflix, Amazon, or CZcams TV series.
I could watch a whole show with these quirky one liners & truth lol.
You always keep it real! Love the brutal honesty and the fact that Dr’s don’t all like this either 🥰
How to wake up an Orthopaedic Surgeon?
“Bones”
Best video yet. I love ortho hanging out on the couch. "Did someone say 'bone'?"
Oh man, this is so true. I have had peer-to-peer conversations that have gone very similar to this.
Meanwhile in Australia, I got an MRI on my neck and my lower back proving I have central stenosis and sciatica. I've been told I need surgery to fix the central stenosis... and it's been 6 months now just waiting to be confirmed onto the surgical waiting list... I have no feeling in three of my fingers on my right hand and they constantly move by themselves... so I've been having *fun*.
I just had an MRI done today at the Veterans hospital. I was supposed to have surgery by an outside provider months ago but VA denied my claim last minute and now I'm starting over.
I have a tumor in my neck somewhere around my carotid artery, jugular vein and vegal nerve. I was an incidental finding when treating my uterine and small bowel cancer. Last year...and I get the VA MRI today. I've been waiting for treatment for over a year.
So far they have been trying to r/o
1. Thyroid nodule (ruled out by ultrasound)
2. Paraganglioma of carotid body
3. Vagal nerve shawnnoma
I have a history of NF1 and cancer...but they will get to it when they can...but they stopped paying my outside Endocrinology oncologist. Now I've been sern for two months by a VA endocrinologist and he is repeating everything that has been done already.
This is SO painfully accurate. Just needed to add that the patient (who has hemiparesis) has to walk to Texaco Mike's to get it covered.
Finally got approved for one and all I had to do was start seeing things pop out of my phone 3D. Had to get my eyes dilated first though to make sure they aren't just being haunted by ghosts
I'm in South Africa and my husband and I are 3 months into a dispute with my medical aid about whether I had cancer or not. I was diagnosed with melanoma that spread to my axillary lymph nodes. I went through two surgeries to remove tumours that were tested by pathologists. Our medical aid fought tooth and nail to deny that I ever had cancer, because then they'd have to pay. To this day they still won't accept that it was cancer.
Most MRI centers will offer a cash price that is usually quite reasonable, often not much more than the deductible. Our cash price is less than the deductible for an MRI scan at the local university medical center. The situation is not ideal, but you can get the scan you need without a lot of spent time and frustration.
I love your work, and I love how accurately hateable you make your loathsome insurance characters.
Great cameo by Ortho.
I don't know what is worse. This, or polish system, where national fund gives every hospital a hard limit on every test and procedure they can do every year.
There are so so so many amazing things about this skit. Thank you.
When I did cardiology I remember these phone calls vividly. I would understand having to call for caths, but when had to call for echocardiograms or other non-invasive tests, it was ridiculous.
So, half my family is in medical, ranging from coding/billing to surgical doctors.
Yes, this is legitimately how they act. Minus Texaco Mike.
Here in Austria when I say I need an MRI the only question anybody ever asked me was: how many?
Yeah i was workkin there few months. You guys are very lucky! Amazin place in Graz
I feel your pain, we may get mri's in Canada you just have to wait and wait and wait or the situation is emergent. Lose lose
This has me thinking about putting an MRI in my spare guest room.
I'll beat Texaco Mikes'price.
Poor Ortho got so excited when you said “bones.” But just like the heart, the brain doesn’t have any bones (that we know of).
I am looking forward to your take on the contrast shortage. Especially when docs are having to order an MRI instead of a CT w/contrast. It shouldn’t be a problem right? MRI’s are not backed up for weeks at all
Whatever solution they come up with, rest assured it will be cheaper, worse and permanent.
Mri tech here, this is definatly effecting work flow for us in the hospital/outpatient setting.
This is so accurate, sad, but accurate!😂😭 Having mixed feelings after watching it. Great one like always!!!
I'm the Scheduler behind this MRI. This is true. Texaco Mike is a nice touch.
I think you just inadvertently nicknamed every radiology resident named Michael, “Texaco Mike” hahahha
I am a medical student studying outside the US. Is this really true? I love watching your videos for laughs but this one I find particularly scary.
It's sadly true. The amount of things insurance companies want the pt to do before being approved is nonsense.
Basically the US is a place where people live like they had free health insurance but are only really free to die if they don’t have the money to pay the insanely inflated medical costs.
Meanwhile they’ve bought CT scanners with taxpayer money to put up in airports because of course that’s more essential than putting them in hospitals
It's exceedingly accurate for how funny this skit is. Dr. Glauc himself has a pinned comment about it up there too
No. This isn't the way things go in most circumstances. Sadly, it depends on the hospital you go to.
Edited: I just wanted to add, this is for his brain. Most comments are about knees, shoulders, etc. Brain is put a little higher on the list of importance. Most insurance companies don't care if you fix a joint, PT is way cheaper, and they are hoping somewhere along the way, you get addicted to pills and forget the surgery. It's way cheaper that way.
Unfortunately it’s all too true.
This is 1000% true! A bean counter with no medical credentials has to give your doctor permission for a necessary procedure. Then you pay a huge copay. I don't see why people say the medical system is broken it makes huge profits for insurance companies. That's the point isn't it?
I’m having flashbacks of my treatment at several VA hospitals. Including one PCP who told me to just put a warm compresses on my severe abdominal pain and take Motrin.
Turned out I had large ovarian cysts and had a full hysterectomy outside the VA a few weeks later.
Thank God for good Doctors! The OBGYN who saw me was blown away by the VA and made sure to write it up in such a way that it was authorized immediately!
Thanks for this lol as an MS patient a yearly MRI is needed so this is soo sincere.
There better be a future episode with Texaco Mike
Man! only one question, is this for real? Like patient has to do PT even before getting a diagnosis? USA is weird.
100%
It's an exaggeration, but things like this do occur occasionally. It isn't common.
Ortho napping in the back waking up only when bones come up was cute
Imagine a world where you didn't have to pay for imaging (or other facets of healthcare) as long as it is indicated... oh wait, that's every other western country in the world.
Keep the good videos coming Dr G
I had no idea this was how things worked in the US before I started watching your videos. Your channel is not only funny, it's educational too :)
As a European, this is just surreal
I had to get an MRI done my ankle after a severe sprain refused to heal. Went through basically this exact process trying to get it approved, only I could barely walk and got sent across town for a 6 am MRI
I love how you’ve kept your inner child alive with that marker mic.
The healthcare system needs radical reform. Thank you for the comedy calling out the shitty current system.
I just finished chemotherapy for a brain tumor and I couldn't be happier that I don't live in America.
What, you don't want to trust your life to the most heartless and wasteful medical system on the planet?
@@TD32333 No thank you♡
@@TwoAllNighters Are you sure though?!
Jokes aside, hope you're doing alright.
Congrats on finishing chemo! Where do you live?
A brain tumor is one of the potential causes for the symptoms I'm experiencing, and my specialist ordered an MRI. And my insurance company - who I pay money to "cover" me - just denied the prior authorization that my specialist sent over. Woohoo, great job, America.
So tomorrow I get to call the doctor's office and figure out how we appeal. A great use of her time and mine. I bet she doesn't have any other patients to treat! The good thing: I hear that the appeals usually succeed. But I can't exhale until I know. (Oh, and authorized doesn't mean the insurance company pays for all of the MRI cost. Most people still have to pay anywhere from $50, if they're lucky, up to thousands of dollars. That depends on their insurance plan and local provider costs.)
I'm not trying to one-up you or anything. If I have a tumor, it's probably benign. It's not likely I will need chemo. So your condition sounds scarier than mine! But my mom has survived brain cancer twice... so I can't rest until I know what's going on and how to tackle it.
Not that it should matter, but I'm 36 and an educated, fully-employed homeowner. And even with these advantages, I'm still facing this. It's even worse for many Americans. It breaks my heart.
I hope you're feeling well! Brain tumors suck.
@whateverlolawants I'm from the UK, the NHS have been under a lot of stress lately but the care I got was incredible.
and don't worry you're totally valid!! My tumor was also benign but was growing enough to need treatment. It is inside of my optic nerve so I couldn't have surgery without likely losing my sight. Chemo didn't make it go away completely but it is smaller and stable now!! I wish you the best of luck with your health, I can't imagine how much unnecessary stress having to fight insurance companies adds, but you got this!