Program Notes
The New MSAA MRI Institute:
Helping People to Better Manage Their MSHow can an MRI be useful after theinitial diagnosis?
MS activity is often sub-clinical, which means that it may continue to progress
without any outward signs of new or increased symptoms. An MRI gives physicians
a picture into this type of disease activity, allowing them to see if a treatment
has stopped or slowed MS activity, or if progression is continuing – in
which case a doctor may want to discuss other treatment options with his
or her patient. Using an MRI to evaluate MS treatment can be very helpful
to the attending physician and the individual being treated.
How does the program work?
The Institute provides the following services to individuals who have been
diagnosed with MS and who are in need of a new MRI to assess disease activity
and progression:
1. The Institute offers advocacy services for persons whose insurance company
is reluctant to pay for an MRI. The Institute will work directly with individuals,
their physicians, and their insurance companies to help secure payment from
their carriers.
2. The Institute may provide payment to cover the cost of MRIs for uninsured
persons.
3. The Institute may provide financial assistance in meeting insurance co-pay
or deductible requirements.
Here’s how one person was helped…
An MS client from Wisconsin needed a new MRI exam to better assess his disease
progression. His doctor requested it, but his insurance company denied the
coverage. He was stuck and in need of someone to get involved and advocate
on his behalf. He learned of the new MSAA MRI Institute from MSAA’s
web site (www.msaa.com).
The Institute worked with the client to fully understand his problem, consulted with all parties involved, including the physician and insurance company, and helped facilitate a solution. In this case, the client needed a critical letter of medical necessity for the exam by the doctor. The letter was submitted, the insurance company agreed, and the client received the MRI he so desperately needed.
Who is eligible and what arethe requirements?
1. Advocacy services will be provided to referred patients regardless of income.
2. For financial subsidies, only individuals with an annual household income
(per family size) of no more than 200% above federal poverty guidelines may
qualify.
3. Referral and certification are required from a physician attesting to the
need for a cranial MRI to evaluate disease progression.
4. The Institute will also need appropriate insurance information, including
statements of no insurance coverage, letters of denial of MRI coverage, and/or
co-pay deductible thresholds.
What types of MRI are included and who should be contacted for more information?
To help those who are not comfortable with closed MRI units, the MRI Institute
also offers assistance with open MRI exams. If you areinterested in applying
for or learning more about the MSAA MRI Institute, please call MSAA at 1-800-532-7667,
ext. 120 or email: mriinstitute@msaa.com.