Rads Denied???

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  • Bren-2007
    Bren-2007 Member Posts: 6,241
    edited January 2008

    Yippee!  Enjoy the weather and the dirt!!

    Bren

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  • saluki
    saluki Member Posts: 2,287
    edited January 2008

    What a gem of a Doctor.  So happy for you.  Unfortunately, this is not an unusual tactic for some insurance companies---the more roadblocks-the longer they can keep the money in their own pockets. ---and they call this cost containment?

    Usually, they wind up approving the procedure in the end.

    Glad this is off your head.

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  • TenderIsOurMight
    TenderIsOurMight Member Posts: 4,493
    edited March 2008

    Thank goodness medicine may still be practiced as it ought to be!

    Hopefully, your insurance letter will be copied to your state Insurance Commissioner for action. They must know about companies attempting such.

    Wouldn't surprise me if your company said, "oh we read it wrong and thought she was 1 to 3 nodes." 

    Argggh,

    Tender 

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  • Little-G
    Little-G Member Posts: 647
    edited January 2008

    Right on!  Keep us up to date on the appeal OK?  I doubt you can switch ins. companies, as now we all have a "pre-existing" on ourselves.  But..it may depend upon what state you live in too?  I don't know.  Good news for now!!  Enjoy the outdoors!

    g

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  • Anonymous
    Anonymous Member Posts: 1,376
    edited January 2008

    Gina, it's sooooo good to hear that your doc is a REAL doc!  And, the insurance should have to pay!

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  • Raye99
    Raye99 Member Posts: 1,350
    edited January 2008

    G,

    I was reading through the posts and saw your last! Yippee. So glad you found a caring and kind doctor; like someone else mentioned - rads is no fun but decreases our changes of recurrence! I had a mast as well and had to have rads (5cm and 3 nodes)- no problem with ins. yes, it is medically necessary and should definitely be covered.

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  • newter
    newter Member Posts: 4,330
    edited January 2008

    Good for you Gina.  What a great doctor.

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  • nosurrender
    nosurrender Member Posts: 2,019
    edited January 2008

    I am so relieved. I never thought I would be happy about starting rads!

    I hated it the last time I had it- but hey- it WORKED last time!

    So tomorrow is my first day at the George Forman Grill.

    Got my dots, my sharpie marks and my Biafine- ready to roll!

    I will DEFINITELY keep you all updated on what happens with the insurance company!! 

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  • Calico
    Calico Member Posts: 1,108
    edited January 2008

    Cheeech,

    I am glad you get to start treatment.

    I had only one node and micro invasion, got my expanders deflatet and radiated.

    I would have suggested the media in the light of the recent news of denial of a liver transplant to a young girl....maybe then they would listen.

    This cannot be real....4 nodes....give me a break!!!

    Hope the tension falls of and you have a good start tomorrow.

    Sending you good vibes and prayers!!!!

    Hang tough!!

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  • Bliz
    Bliz Member Posts: 507
    edited January 2008

    Way to go, G!!!  So glad the doc worked it out for you.  There are little miracles along the way.

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  • PuppyFive
    PuppyFive Member Posts: 2,808
    edited January 2008

    {{NS}}

    Good Luck, My Sister!

    Puppy

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  • Rebecca
    Rebecca Member Posts: 971
    edited January 2008

    Oh Gina I am so glad to hear about this!  Our medical system is absolutely PATHETIC.  The drone that denied your rads should be drawn, quartered, and then roasted on a REAL george foreman grill! 

    I had a breast MRI last may, and my insurance paid for the procedure, but would NOT pay the $150 for the CAD that the dr MUST perform in order to read and interpret it.  I was advised that without the enhancements that result from the CAD procedure a breast MRI is basically worthless.  My appeal went to the highest level, and it was STILL denied.  The MRI place has removed the charge from my account, but I am still thinking I should pursue it because I am sure that this is NOT my last breast MRI.

    RIDICULOUS!!!

    well anyway, I am glad you got such a wonderful break....your Dr deserves warm, freshly baked chocolate chip cookies! 

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  • MrsBee
    MrsBee Member Posts: 124
    edited January 2008

    That is the most ridiculous thing I've ever heard - an insurance company deeming rads "not medically necessary" when your doctor says they are!

    I'm so glad to hear also that they are going ahead and starting your treatments while they unscramble this mess.  I applaud your doctor for putting the patient first in this case!

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  • flash
    flash Member Posts: 1,685
    edited January 2008

    Fabulous for you. Your Onc is truly a great doctor. Hope all goes well.

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  • Anonymous
    Anonymous Member Posts: 1,376
    edited January 2008

    Gina:  You must come and tell us how you are doing with the RADS.  Im hoping all is going well.

    Saluki:  Yep when it comes to insurance companies its called delay and deny.  Saw a special about it on 60 minutes.  Very sad.

    nnn

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