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STW
Regular Member


Date Joined Jun 2009
Total Posts : 292
   Posted 5/13/2011 4:54 PM (GMT -6)   
As some of you may remember my SRT was delayed over a week because the insurance company had boxes to check. I had my weekly meeting with my radiation oncologist and learned the biggest holdup was the need for their doctor to talk with my doctor. The case management folks said the biggest question was about the need for daily imaging prior to the IMRT.

Now, I was able to answer that particular question in about 3 minutes using Google, giving me some concerns about the insurance company doctor and their whole understanding about how IMRT works.

It turns out the "peer" was a chemotherapy doctor. My doc's opening gambit on learning that was, "You don't know what I do, do you?"
"No"
"Then why are we talking?"

Understand my doc is the department chair and one of the reasons it took so long to "peer review" is that he was in DC testifying to some committee or another. I don't believe he suffers fools gladly. It's too bad this disease locks me into my insurance for probably five years. Apparently, I should have changed 3 years ago. Who knew?

Other news. Five radiation treatments down. 33 to go.

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6949
   Posted 5/13/2011 5:20 PM (GMT -6)   
My insurance is supposedly one of the better ones. They approved (in writing) implating my Calypso markers for IGRT, but then reversed the decision and would not pay for the scan to verify them every day (that was considered essential by the RO, and they scanned anyway). It was supposedly "experimental", although the VA has that equipment in use in the same manner all over the country. That is a battle that is still ongoing.
 
Interesting that the much-maligned, supposedly inept VA uses so much "experimental" equipment.
 
You would be amazed how much I've had to appeal at one level or another.
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