I Hate Dialysis Message Board

Dialysis Discussion => Dialysis: Medicare/Insurance => Topic started by: sullidog on April 04, 2012, 12:36:38 PM

Title: medicare denied me for vesel mapping
Post by: sullidog on April 04, 2012, 12:36:38 PM
So a while back I requested to have a vesel mapping done because I wanted to see if I could switch from a graft to a fistula and my v surgeon agreed, plus he wanted to see since I've had so many access issues see if in case I had permanet access failure if he could find something else available. well medicare denied the claim after it was done, well my v surgeons company appealed it and I get a letter this week saying the appeal was denied because the services were unreasonable and unecessary. I'm thinking how? That's my lifeline and without one I can't get dialysis, it looks like we can appeal again but I'm afraid if I do they'll deny again, how can we show that this was a necessary procedure? Should we have a third party help us? If it ever came time where I did have to get a new access without that vesel mapping he wouldn't have a clew where to make one, do you think they are denying it because I already have a working access?
Title: Re: medicare denied me for vesel mapping
Post by: Jean on April 05, 2012, 12:36:57 AM
Personally, I think they are denying it because they dont know what they are talking about. Keep fighting!!!
Title: Re: medicare denied me for vesel mapping
Post by: jeannea on April 05, 2012, 12:53:58 PM
That's rather mean of them. Maybe wait a little and try again? Then maybe you'd get a different claim reviewer.