cmb Posted October 24, 2011 Share Posted October 24, 2011 Hello, my mom has SCLC with mets to the abdomin and nasal cavity daignosed on 12/24/2010. Last Monday we discovered her chemo was not having any affect on the tumor in her sinus and she needed radiation to this area. She was supposed to start that treatment today, BUT we received a call Friday afternoon that her inusrance had not authorized the treatment yet. She was on the phone most of the day on Friday and again this morning and it is STILL not resolved. We are very frustrated without this, the tumor has the chance to spread to her brain and then it will be too late. She has private insurance for which she's paid premiums on for years and until she got sick never really used. Since when do people with no medical experience sitting behind a desk get to say what is the best treatment for a patient? ( on a side note, I am a medical assistant and fight with insurance companies on a daily basis for my patients) Any one else have a similar issue? Thanks, Cora Quote Link to comment Share on other sites More sharing options...
dianew Posted October 24, 2011 Share Posted October 24, 2011 I had an issue with the PET scan, and I've also had some issues with some of the anti-nausea meds during chemo. The cancer center had an "assistance" person who dealt with the insurance companies on my behalf. As far as I can remember, they got everything through although they didn't always get what I needed when I needed it - and it took 3 weeks to get an OK on the PET scan. I would call your Mom's oncologist's office and see what they can do to help out with this. Hopefully someone else will be along with better advice. Best of luck. Diane Quote Link to comment Share on other sites More sharing options...
Alan Posted October 25, 2011 Share Posted October 25, 2011 The insurance co. should have a patient advocate on board. Make calls, pester people. Quote Link to comment Share on other sites More sharing options...
Nick C Posted October 26, 2011 Share Posted October 26, 2011 I was going to say, patient advocate at insurance co. Someone may also be tasked with this type of stuff at the cancer center. Finally, insurance is regulated by state board of insurance...contacting them usually makes insurance cos responsive. Quote Link to comment Share on other sites More sharing options...
Ry Posted October 26, 2011 Share Posted October 26, 2011 The doctor has someone on staff that does this - it happens all the time (unfortunately). They know just how to word things to get them approved so let them do it. Quote Link to comment Share on other sites More sharing options...
eric byrne Posted October 26, 2011 Share Posted October 26, 2011 Prayer for the day, Oh Lord,may the American Public one day soon, wake up and accept the adoption of a similar National Health Service that I take for granted not only in the United Kingdom,but throughout the whole of European Economic Community and in other developed world economies. Take away from the American public all those tiers of business practices that exist in making money out of peoples illnesses. Amen. My sincere apologies to any one who finds this even slightly political or irreligous. Quote Link to comment Share on other sites More sharing options...
Joppette Posted October 26, 2011 Share Posted October 26, 2011 My answer is the same as the others. Patient advocate. I was assigned one with my Insurance Company and she was a tiger for me. MI Judy Quote Link to comment Share on other sites More sharing options...
eric byrne Posted October 26, 2011 Share Posted October 26, 2011 Prayer for the day, Oh Lord, may the American Public wake up one day soon to the adoption on the National Health Serice that I take for granted in the United Kingdom and in the whole of the European Economic Community also all the other developed world economies. Take away all those tiers of business practices that exist in making money out of peoples illnesses. Amen. My apologies to anyone who finds this even slightly political or irreligous. Quote Link to comment Share on other sites More sharing options...
eric byrne Posted October 26, 2011 Share Posted October 26, 2011 Ooops my apologies for posting the same article twice,I didnt think it went first time,thats me now twice in trouble LOL. Quote Link to comment Share on other sites More sharing options...
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