PT in order to get mri?

[Anonymous]

I was referred to a neurologist for some issues. Dr wants to send me for a spine mri but is worried insurance will not approve it unless I will do first few session of physical therapy. Is this a new protocol?

[Anonymous]

I think it's pretty standard.I had acute severe back pain last year and had to do six weeks of PT (if I'm remembering correctly) before my insurance would approve an MRI. MRI showed a herniated disc.

[Anonymous]

Standard requirement for as long as I’ve had insurance. You can try and fight it with your insurance company.

[Anonymous]

Yes

[Anonymous]

It depends on your insurance.

[Anonymous]

My neurologist has sent me twice for MRI and I never needed to have done any PT or other steps prior.

[Anonymous]

It de-ends on your insurance. You can call them and ask. Your doctor might be giving you blanket advice.

[Anonymous]

Anonymous wrote:I was referred to a neurologist for some issues. Dr wants to send me for a spine mri but is worried insurance will not approve it unless I will do first few session of physical therapy. Is this a new protocol?

I've had back issues my whole life, and this has never been my experience. An x-ray, maybe, but PT before imaging sounds like a MASSIVE liability, and a red flag. How is a physio supposed to know what work to do without a clear understanding of the issue(s), especially if they're structural? I don't look nearly as defective as I'm actually built, and wouldn't trust a treatment plan that counted on moving my back without a clear view of what needed moving.

Verify this with your insurance, at least. Personally, I'd seek a second opinion, or just switch providers entirely.

[Anonymous]

If you have UHC, yes.

[Anonymous]

I'm a PT and yes this is a requirement for many insurances. Usually it is 6-8 visits (I've never seen 6 weeks). On rare occasion it is clear the patient needs an MRI and our PT sessions are largely performative, but honestly many people are able to avoid the MRI due to feeling better. For the post above who says this is a liability, you have to trust that your PT would contact the MD if there really is a medical emergency that would contraindicate PT. The vast majority of issues are not and we are trained, licensed professionals.

[Anonymous]

Anonymous wrote:I'm a PT and yes this is a requirement for many insurances. Usually it is 6-8 visits (I've never seen 6 weeks). On rare occasion it is clear the patient needs an MRI and our PT sessions are largely performative, but honestly many people are able to avoid the MRI due to feeling better. For the post above who says this is a liability, you have to trust that your PT would contact the MD if there really is a medical emergency that would contraindicate PT. The vast majority of issues are not and we are trained, licensed professionals.

OP here. Thank you for the clarifications; I checked and indeed my insurance has this requirement. Initially my issues (after xray) were considered caused by some findings in the spine but neurologist has a different opinion and thinks the findings are accidental and the issues may be caused instead by inflammation. At this point I will just go to PT and see how it goes

[Anonymous]

Anonymous wrote:

Anonymous wrote:I'm a PT and yes this is a requirement for many insurances. Usually it is 6-8 visits (I've never seen 6 weeks). On rare occasion it is clear the patient needs an MRI and our PT sessions are largely performative, but honestly many people are able to avoid the MRI due to feeling better. For the post above who says this is a liability, you have to trust that your PT would contact the MD if there really is a medical emergency that would contraindicate PT. The vast majority of issues are not and we are trained, licensed professionals.

OP here. Thank you for the clarifications; I checked and indeed my insurance has this requirement. Initially my issues (after xray) were considered caused by some findings in the spine but neurologist has a different opinion and thinks the findings are accidental and the issues may be caused instead by inflammation. At this point I will just go to PT and see how it goes

PT here. That is a good and appropriate plan! Good luck!

[Anonymous]

Anonymous wrote:I'm a PT and yes this is a requirement for many insurances. Usually it is 6-8 visits (I've never seen 6 weeks). On rare occasion it is clear the patient needs an MRI and our PT sessions are largely performative, but honestly many people are able to avoid the MRI due to feeling better. For the post above who says this is a liability, you have to trust that your PT would contact the MD if there really is a medical emergency that would contraindicate PT. The vast majority of issues are not and we are trained, licensed professionals.

The vast majority of you perform an intake and then farm out responsibility for subsequent visits to people with far less training.

I stand by my previous statement, and you might want to consider your own liability here. That whole "do no harm" thing and all.

[Anonymous]

Anonymous wrote:My neurologist has sent me twice for MRI and I never needed to have done any PT or other steps prior.

+1

[Anonymous]

Anonymous wrote:

Anonymous wrote:I'm a PT and yes this is a requirement for many insurances. Usually it is 6-8 visits (I've never seen 6 weeks). On rare occasion it is clear the patient needs an MRI and our PT sessions are largely performative, but honestly many people are able to avoid the MRI due to feeling better. For the post above who says this is a liability, you have to trust that your PT would contact the MD if there really is a medical emergency that would contraindicate PT. The vast majority of issues are not and we are trained, licensed professionals.

The vast majority of you perform an intake and then farm out responsibility for subsequent visits to people with far less training.

I stand by my previous statement, and you might want to consider your own liability here. That whole "do no harm" thing and all.

I was in PT recently and after one visit, some assistant took over. The therapist was not very involved. Such a waste.