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Old 02-18-2011, 09:47 PM
Maria Maria is offline
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Join Date: Sep 2006
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One of my previous CA PM providers did get sort of upset because I chose to get my ESIs with an anesthesiologist that didn't work with the PM practice. My current PM told me outright that's what PMs make their $ off of not the office visits for scripts so the $ is in the injections (ESIs and other).

Now WC no longer authorizes ESIs for me so I'm hoping this PM will continue to see me just for prescription refill. I normally see him every 3 months just for scripts now and I travel several hours to see him as I have a very good rapport with this PM of the last 6 years.

Good luck getting someone to see you. May take a while. I wouldn't want to waste an insurance copay if I were paying out of pocket or my time sending records back so I personally do inquire about the practice and whether the PM prescribes medicines, does injections and so forth. In the past I wouldn't have wanted to go to one that didn't prescribe medicine or do injections (ESIs). Not saying you have to tell your whole history over the phone but in order not to waste your time you might want to ask some routine questions of your own regarding the practice to make sure it's what you're looking for before agreeing to send records. I have usually asked to speak the office manager about this and never had a problem with getting information about the practice.

I got a Nurse Case Manager when my 2nd spine surgery failed and I was deeply depressed and verbalizing some pretty "deep" thoughts/emotions that were "red flags" to bump up my level of care and case management. The insurance companies don't usually pay for a case manager unless it's deemed necessary as it's an added expense to them. Since I decided not to have another surgery after a number of years my Nurse Case Manager was pulled.

Last edited by Maria; 02-18-2011 at 09:53 PM.
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