ER visit denied
My recent visit to the ER was denied by Aetna. They stated :
“Services do not appear to support the prudent layperson definition of emergency. This presenting symptom of chronic lower back pain does not appear to represent a clinically emergent situation necessitating use of the emergency department setting as there was no reasonable, imminent threat to life or body function apparent in the medical documentation and other facilities may have been an option on the day of the Emergency Room visit “
I called my PCP before going to ER, I couldn’t walk, so she told me it was best to go to ER. I’ve been back and forth with hospital and health insurance. This has been so overwhelming.
The ER gave me an MRI and it showed I have multiple bulging discs. But the notes on file were not detailed enough and the hospital didn’t include pain scales.
Is there any advice/ tips to help me get this approved. Anything is appreciated.. this has me stressed it’s a 12k bill.
submitted by /u/No-Librarian-6077
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