Anyone else have scans this week?

BevJen

Lehrski,

Oh, I misunderstood -- think I focused on the fact that you said your were Canadian and a US resident -- I missed the insurance part.

You could ask your HR department how your can access the information booklet for your insurance -- you are right -- that is generally a good insurance. Sometimes, if you work for a big company, they are "self insured" and the insurance company is really only a functionary -- so that the company is really setting the parameters for the insurance, and the insurance co. does the claim processing, etc. That could be what is going on.

nopink2019

lehrski, you said you are not very familar with ins. Could it be that you haven't met your deductible? My MO has me do detailed bloodwork each month even though I only see her about every other. But those trends can be a good indicator of when more scans might be necessary and helpful for treatment decisions.

lehrski

I work for the state of CA so it’s a huge insured group and likely have their own rules. Unfortunately, the preauthorization was denied. My oncologist then submitted an appeal that was denied. Finally, he asked for a “peer to peer review” with the insurance company. My oncologist said he spent about 45 minutes arguing my case, but it was denied again. I’m impressed by my oncologist’s tenacity but the insurance company won. The only way I can get a scan is by paying cash and not using my insurance at all. The worst part of it is that cash rates are much more expensive than what insurance companies pay.

I am doing both CA 15-3 and CA 27-29 tumor marker bloodwork each month They have both dropped into the normal range. While they’re somewhat unreliable, for now I things are good and I might wait a bit before paying again for a scan