Guest Mary Ann Posted October 10, 2003 Share Posted October 10, 2003 I have been reading this Message Board for over a year. I have received some wonderful advise just by reading other messages. This is the first time I have signed in with a question. I have a question that I hope someone can help me with. I have been approved for RFA (Radio Frequency Ablation), but my insurance company has denied the pre authorization request. I live in Michigan and I hope to have the procedure done in Auora, IL. I am blessed to have very good Health Insurance. Unfortunately, they have denied my request for this procedure. Does any one have any ideas on how to get this approved? Has any one received insurance coverage for this procedure? Mary Ann Stage IV - Non Small Cell Diagnosed - February, 2002 Upper left lung removed March, 2002 Quote Link to comment Share on other sites More sharing options...
norme Posted October 10, 2003 Share Posted October 10, 2003 Mary Ann, Why are they refusing you RFA? You need to know the exact reason then appeal their decision. I have never had any problems with medical insurance in the present or past so only know you can appeal their decision, also call you congressman after you know why and ask him to contact them too. Don't stop there, call the American Cancer Society and ask them what else you can do regarding this denial. Call your TV station and see what they can do for you as far as them calling the insurance co. TV can work wonders. Why do we have insurance if not to use it at a time like this......no insurance company is ever going to tell me no. I would fight tooth and nail for what I need and you must to. Keep us posted as to what occurs... Quote Link to comment Share on other sites More sharing options...
Guest Mary Ann Posted October 15, 2003 Share Posted October 15, 2003 Norme, Thank you so much for some great ideas. I will keep you posted. Quote Link to comment Share on other sites More sharing options...
Ry Posted October 15, 2003 Share Posted October 15, 2003 Norme is on the money (of course). We had to fight over a medication my husband's insurance did not want to pay for. The doctor wrote a letter to the insurance company stating why he needed it, then it went into an appeal process that took forever. The doctor's staff should know where to start to have this approved, they've probably had to do it before. I do believe I have read that this is no longer considered experimental for lung cancer so they can't use the excuse that it's not standard treatment procedure. I think they all deny at first to see if you'll back down. What was that movie years ago where the insurance company had a procedure of denying bills three times to see if people would give up? It was based on a John Grisom novel. Trivia question. All the best. Quote Link to comment Share on other sites More sharing options...
Eileen Posted October 15, 2003 Share Posted October 15, 2003 I think it was the Rainmaker Quote Link to comment Share on other sites More sharing options...
Ry Posted October 15, 2003 Share Posted October 15, 2003 Yep that's it. You get to move on to the final round. Quote Link to comment Share on other sites More sharing options...
Guest Mary Ann Posted December 5, 2003 Share Posted December 5, 2003 Happy to say - - I had the RFA Procedure and the Insurance Company did pay!!!!!! Quote Link to comment Share on other sites More sharing options...
norme Posted December 9, 2003 Share Posted December 9, 2003 Am really happy for you. So glad your insurance co came through. Quote Link to comment Share on other sites More sharing options...
CynMs Posted January 3, 2004 Share Posted January 3, 2004 I HAD NO PROBLEM WITH MY INSURANCE PAYING FOR THE PROCEDURE. I AM NOT CERTAIN IF IT IS STILL CONSIDERED EXPERIMENTAL, THAT MIGHT BE A HANG UP. BUT, IF YOU CAN PROVE, WITH YOUR DOCTORS HELP THAT IT MIGHT BE LIFE SAVING, ANI CERTAINLY IMPROVE YOUR QUALITY OF LIFE, THAT MIGHT HELP. Quote Link to comment Share on other sites More sharing options...
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