The essential details are: My MD says he wants exam X. The insurer says that I must have exam X done at place P. I call place P, I say may MD wants MRI exam X. They say they won't do that, I have to have exam a' b' c', and I can't have them all done on the same day. Too much radiation, they say.
I say I don't understand this; MRI doesn't emit radiation. Well, yes, it does, but so does a light bulb, and you can take that kind of radiation all day. I've had MRI's done before, precisely the way my doctor wants them done, in one visit, and nobody--NOBODY--ever cared. Or even noticed.
Well, we don't do that exam, and what we do do, you can't have on only one day.
As may be, I tell them, but the insurer has approved me for one exam, not multiple, and if I do things the way you want, which isn't the way my doctor wants, it'll triple my cost... if I get this test without "pre-approval," they won't pay for it. Why anyone gets a doctor to prescribe an MRI for fun, or in some other way that needs people who don't know the patient involved to intervene and slow down the MRI-getting process, is beyond me.
Now here's the Zen moment: Speaking with patience, with compassion, to the person on the other end of the phone.
They know less about your condition than you do. They know nothing about the diagnostic system or even basic medical lingo (e.g., what's "on top," cranial, thoracic, or lumbar). They're just reading from the script: Here's the way we do things, therefore that's the way we do things, and that's all there is to it. Bend over and smile, as they say in the proctologist's office.
At this point, it's like yelling at the weather. Yep, it's raining (or isn't), and now what can we do about it?
Nothing. Shigata ga nai, as the Japanese say... nothing to be done.
Which doesn't mean I'm not continuing to find a way around the blockage, but that road can't be plowed by external-to-the-system logic. Perhaps force majeur; if the insurer called and said "Yes, you are going to do it the way he says," it might happen. Might. But that won't happen.
Shigata ga nai.
Pity when one invokes a favorite saying of internees in Manzanar in the face of 21st-century land-of-the-free America, the land where the Insurers rule over all.
Against stupidity, the gods themselves contend in vain. (Friedrich Schiller)