
Michele Mandell
8 posts

Michele Mandell
@MicheleMandell
Reporting from Carmel, Calif.









Hi @BlueShieldCA, I pay $1,875.26/month for your Silver 70 PPO plan. This morning, I paid $1,250 cash for an MRI that you deemed “not medically necessary.” Yet it revealed a complex web of structural damage that finally explains the debilitating pain I’ve endured for months on end. I cannot take basic care of myself — and you don’t care. I deleted my Twitter account years ago. I had a strong following (former publicist). But I’m starting from scratch here, so I’m a “nobody” on X. Just like I’m a nobody to Blue Shield. I imagine that if your CEO needed an MRI to determine why she couldn’t walk, she would get one immediately. For me, you demanded: • A useless x-ray (that showed nothing) • Four weeks of PT before even considering authorizing an MRI This would have meant many more months before (possibly) getting this critical diagnostic information. I can’t even get in and out of my car, or go up one step, much less get onto a PT table without excruciating pain. An MRI would have informed a PT where to focus. So I paid $1,250 out of pocket in order to get some answers. It was not easy to figure out how to get an MRI without insurance. And I’m lucky enough to have the wherewithal (intelligence, time, resources) to navigate this nightmare. And now I’m supposed to grovel for reimbursement via your insulting and stressful grievance process? My copay should have been $350, but I’m kissing it all goodbye. Why? Why should I raise my blood pressure and cortisol levels even more by bothering to try? You already told me that you do not care: “This service is not covered because it is not medically necessary.” What a joke. When someone shows you who they are, believe them the first time. (cc: @CarolineYLChen @jenbrea @LizSzabo @PatientsRising @Care4Yourself) #HealthInsurance #BlueShield #InsuranceDenial #DelayDenyDefend #ChronicPain #PatientsNotPaperwork #PriorAuthorization #FixPriorAuth


