Insurance denying MRI (brain) after ascending aortic aneurysm repair. Any help?

[thenewmarket]

My husband had BAV repair and ascending aortic aneurysm repair in September 2007. We are so blessed to have a cardiologist who understands bicuspid aortic valve disease........we had discussed doing an MRI to scan for brain aneurysms while we were still in the recovery stages. After our six month echo/visit our doctor set the MRI in motion. The appointment was for this evening, and we just received a call to reschedule because our insurance denied coverage for this procedure. Our insurance provider has been terrific, and I can't understand their hesitancy to follow through with the rest of the testing.

Even if our insurance doesn't pay, we will follow through as we believe this MRI is imperative. Has anyone else had this experience?

 

[Ross]

That is ludicrous, but I guess I shouldn't be surprised. I would hope your appealing this decision? Get on the phone and get the exact reason why they won't cover it and them lambast them with why it needs to be done.

 

[IREF2]

newmarket - I had the same surgery has your husband one year ago. Did your husband have a history of brain aneurysms prior to the surgery? I am trying to understand the relationship between aortic aneurysms & brain aneurysms and why an MRI is needed.

 

[Superbob]

newmarket - I had the same surgery has your husband one year ago. Did your husband have a history of brain aneurysms prior to the surgery? I am trying to understand the relationship between aortic aneurysms & brain aneurysms and why an MRI is needed.

I, too, am wondering the connection between searching for possible brain aneurysms and the aortic aneurysm. We have experience with both in my household -- my wife had the brain aneurysm, which was surgically capped, and I had the aortic aneurysm and VR, which was fixed with a combined root and valve. But I am not aware of the connection between these two types of aneurysms. Perhaps that is the reason the insurance company is balking at MRI searching for brain aneurysms as well. Is that proposed to be done because of certain symptoms (such as migraine headaches), or just a routine screening?

 

[Duff Man]

It's just kind of a logical test to have done if you have a connective tissue disorder such as BAV, because people with BAV have a (statistically significant) 50% chance of having an aneurysm. If your body has already proved prone to aneurysm, I would think an occasional prophylactic scan of the brain would be prudent to rule out new dilitations etc.

 

[ALCapshaw2]

We've had a rash of BAV with Aneurism patients join VR.com recently and there have been extensive discussions of the relationship between Connective Tissue Disorders (which can result in aneurisms) and BAV.

Someone reported that there was a 75% correlation to one type of Connective Tissue Disorder with BAV patients. Some Cardiologists / Surgeons have noted Brain Aneurisms in BAV patients and 'suspect' there is a connection. Supposedly some studies are underway to establish and quantify the connection.

See the "aneurism" (or "aneurysm" I forgot which spelling was used) thread in the Heart Talk Forum, started by ---- and his sequel "bicuspid aorta aneurism". These threads ran in early April 2008.

'AL Capshaw'

 

[ALCapshaw2]

My husband had BAV repair and ascending aortic aneurysm repair in September 2007. We are so blessed to have a cardiologist who understands bicuspid aortic valve disease........we had discussed doing an MRI to scan for brain aneurysms while we were still in the recovery stages. After our six month echo/visit our doctor set the MRI in motion. The appointment was for this evening, and we just received a call to reschedule because our insurance denied coverage for this procedure. Our insurance provider has been terrific, and I can't understand their hesitancy to follow through with the rest of the testing.

Even if our insurance doesn't pay, we will follow through as we believe this MRI is imperative. Has anyone else had this experience?

Contact your insurance company,
ask how to file an appeal and what information they require, and back up your appeal with a LETTER from your Cardiologist.

Some insurance companies provide a Nurse Case Manager to coordinate Patient Needs and Insurance Benefits for major medical issues. It wouldn't hurt to ask about that 'service'.

Good Luck!

'AL Capshaw'