MMI Doc Refusing to See Me

[Ouch1]

I tried to make an appointment today with a doctor who put me at MMI (I think, I was just told I wasn't allowed to see him any more) about 6 months ago. His office is refusing to make an appointment, stating that the insurance company has to do it for me. My prescriptions are low and need refilling ASAP. What can I do? He is one of the approved doctors through the insurance company. I know the insurance company won't do this. They are refusing to send me to other doctors, that are prescribed. I thought I could see him whenever I needed to and if he put me at MMI, 10.00 copay. I see other doctors this way.

[BvIA]

Where is your attorney? That is where this should be addressed...

[ADJ]

He is not refusing to see you but needs authorization from the carrier. Call the adjuster and tell them you need to return to the doctor. If they fail to do it then your attorney needs to file a PFB.

[tony]

Ouch1

(I think, I was just told I wasn't allowed to see him any more) about 6 months ago.

My prescriptions are low and need refilling ASAP.

Med checks are usually done on a monthly basis, not every six months.
They're not about to prescribe six months of meds and not make another appointment, something doesn't add up here.
What did they tell you at your last appointment, they should've scheduled another med check before your meds ran out.
I've never heard of a doc prescribing six months worth of meds, depending on the drug, it would be illegal.

Tony

[complwyr]

You (or your lawyer, if you have one ) must get in touch with the insurance adjuster and ask him or her to authorize a visit to the doctor. Period. That is the only way it is going to happen.

[Ouch1]

Seems the office policy trumps the state law. My lawyer had to threaten them in order to get an appointment.
Yes, this particular doctor is a glorified drug dealer. This guy is a pawn for the insurance companies. He doesn't care about patients. He has a good facade in an affluent neighborhood. When I finally got into see him and all he wanted to know is what drugs I wanted and was annoyed when I asked him questions about my condition. (I'm not taking any narcotics, nor did I ask for any...even though I am in serious pain.) He refilled me for another 7 months and told me to, 'just settle already.' He's not interested in actually helping my condition. When I pleaded with him for help, he told me he was going to write to the carrier and tell them I'm still not well. That contradicts the MMI. That would be doctor #2 that has done this to me now.
If these doctors feel they don't make enough money off WC cases, then why do they agree to take them? Oh wait, I know. Easy money...Turn and burn. They don't have to really DO anything for their money. If they see enough WC/medicare patients, they can make a good, easy living. Not to mention kick backs and perks from the insurance companies and big pharma.

[hubertmcintosh]

Believe in yourself I know you overcome this. Have faith in God, he heals you and guide you always.

[allbummedup]

I am fortunate to have an AA and I see my MMI Surgeon when I ask to. I had been sent to a pain mgmt. center and it was a joke. the doc was way too confident, and made a damaging report about my case. The pain mgmt. center is very big, but, the staff cannot hear you correctly when you speak, and the doc is an insurance trollop. Now this is another hurdle along this endless road. Vicious game we are in, but we have to be ugly sometimes to those who are supposed to be helping us to get the help we KNOW we are entitled. Call repeatedly to your AA and adjuster until you are seen. That's what I would do..after all, we have the time, right?? What's up with a $10 co pay?? I have never spent a dime.

[aquafina]

Ouch

I am having the same situation just today after the appt was set three weeks ago. I got a call from Atty yesterday said everything was okay and approved for the visit and then today the MMI Surgeon says no to seeing me. Is this because I have retired? I have not settled the case yet so I am at a loss for words here. WHo treats me now with my ongoing knee pain? Any help out there. I also am on SSD so there was some mention of a medicare set aside but I have no knowledge as I have not signed settlement papers yet. Can the doctor refuse to see you for no reason or is there something else hidden from the story?

Frustrated in Florida

[complwyr]

If a surgeon thinks you are at MMI he is not going to see you. Why? Because MMI means "maximum medical improvement." The surgeon can't improve you any further by seeing you again. Therefore he is not interested in seeing you. Maybe his office will refer you to pain management. That is what the surgeons do here in NC when MMI occurs but the IW still has a lot of pain.