G.A.M. Posted July 13, 2021 Share Posted July 13, 2021 I try not to get too anxious, but my week has come off the rails. In short, the request for a CT Scan has been denied based on the kind of tumor I had removed. Because it can secrete as a hormone and based on treatments, they allow one CT after surgery between 3 and 12 months, then once a year for three years, then every other year until I reach ten years. They don't say what happens after that. I'll still get the bloodwork and an echo-cardiogram, I guess, but I see no reason to see the oncologist if his primary tool has been taken away. So frustrating. Best to you all. Link to comment Share on other sites More sharing options...
LexieCat Posted July 13, 2021 Share Posted July 13, 2021 I'd be frustrated, too! Have you talked to your oncologist about this? I don't know whether this makes sense from a medical standpoint or not, but I'd sure want my oncologist to weigh in on it, and challenge it if the CT scans are medically necessary. I noticed when I got a recent notice of denial of payment for the Keytruda given during my last maintenance treatment that the decision was made by a board-certified RHEUMATOLOGIST. Not someone I'd have making medical decisions for lung cancer. My team at Penn is working on getting to the bottom of it. I'm sure it will be straightened out eventually (I'm assuming the decision was based on the radiologist's report noting possible progression--never mind that my oncologist disagreed till the next scan left no doubt). Glenn, we gotta speak up for ourselves in these situations. The doctors can help but they don't always know what's going on with the insurance companies. I think my first call/email would be to my oncologist and see what they have to say about the insurance company's decision. And then ask for help appealing it if necessary. Link to comment Share on other sites More sharing options...
LexieCat Posted July 13, 2021 Share Posted July 13, 2021 Oh, and one other thing. I'd keep seeing the oncologist regardless of scan frequency. They are the experts in lung cancer and might pick up on signs/symptoms that are important for follow-up. Link to comment Share on other sites More sharing options...
Rower Michelle Posted July 14, 2021 Share Posted July 14, 2021 Glenn, This is becoming a much bigger problem- for all of us. Here’s a step by step guide on how to fight back the insurance denials. Ditto to what Teri said. Link to comment Share on other sites More sharing options...
TJM Posted July 15, 2021 Share Posted July 15, 2021 This sounds wrong on many levels. Time for a second opinion I think? Keep up the good fight my friend Peace Tom Link to comment Share on other sites More sharing options...
G.A.M. Posted July 20, 2021 Author Share Posted July 20, 2021 I underestimated the powers that Oncologists possess. I had bloodwork today. Some numbers were high and some were low and the rest normal. I understand the individual CBC components, but I have no idea how Doctors see them. Tomorrow is the CT and echocardiogram. I’m more worried about the echo than the CT. My PCP says she hears a problem with a valve. I had major heart surgery more than fifteen years ago and do not want to go through that again. Wednesday, I see the Oncologist. I doubt I’ll get a peek at the scan results before I see him. Best, Glenn Link to comment Share on other sites More sharing options...
BridgetO Posted July 20, 2021 Share Posted July 20, 2021 Fingers crossed for yo, Glenn. Link to comment Share on other sites More sharing options...
G.A.M. Posted July 21, 2021 Author Share Posted July 21, 2021 This was cancer checkup day. Still cancer-free. Woohoo! I go back in four months with just a chest X-ray. Thanks for your support, all. Best, Glenn Link to comment Share on other sites More sharing options...
Rower Michelle Posted July 21, 2021 Share Posted July 21, 2021 Yeah! That is great news!!!! Link to comment Share on other sites More sharing options...
BridgetO Posted July 21, 2021 Share Posted July 21, 2021 Happy dance for you! Link to comment Share on other sites More sharing options...
Tom Galli Posted July 22, 2021 Share Posted July 22, 2021 Wonderful!!! Link to comment Share on other sites More sharing options...
LouT Posted July 22, 2021 Share Posted July 22, 2021 Fantastic news! Lou Link to comment Share on other sites More sharing options...
TJM Posted July 23, 2021 Share Posted July 23, 2021 Well gosh darn it that's great news GAM. You and I are on similar paths. Love the scan news...do not fear anything else. If there is one positive to cancer is we get scanned and tested so much we can catch other crap early! Your post made my day and it was a really good day before! Peace Tom Link to comment Share on other sites More sharing options...
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