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I am now on the "maintenance" chemo, which is a pill for 5 nights followed by 23 days off, followed by 5 days on, etc., until the docs decide I'm ready to go off or try something else. I've been in Lubbock for two weeks and have enjoyed being with my little family, seeing friends, and getting into work some. [...]
If you are keeping up with the class readings, you know that Wednesday was scan/ check up day at MD Anderson and you'd be much better at keeping up than are my students in my class. We flew into Houston late Tuesday night and were up at 5 am to get to my 6:15 scan. Of course, when we got there we found out that there was a flag on my account that was ambiguously related to the insurance approval. I had received a letter a day or two before we went that said the MRI was pre-approved. Of course, I forgot to take it with me because I assumed that MDA would also have been notified. I was wrong, as not only did they not have the pre-approval letter, the insurance was also claiming that there was no referral from my PCP. When BCBS took over as the overseer for the state of Texas medical insurance, I was required to have my PCP give another referral for MDA. This was done and I have not had any trouble from January until this week. So why did the insurance claim there was no referral? I have no idea. Luckily, I have the best PCP ever and we were able to find him via telephone and he immediately had his people make the necessary referrals. MDA did the scan because they could see that the insurance has been covering me for all of 2018. Of course, since BCBS has outsourced their claims department and the claims department has been rejecting approximately 80% of claims (even after the medical side pre-approves procedures and tests), I'm sure the claim will be rejected when they get it. I still haven't seen any payments for the proton therapy even though we have plenty of evidence in both writing and recorded conversations that those procedures were all approved. Since claims won't pay anything, I can't get reimbursed for the cash I laid out. I guess the strategy is to hang on to the money for as long as possible. This is fine because after I've gone to the media, I will just make sure my attorney sues for lost interest, stress to a cancer patient, and consulting fees for my time writing up my insurance appeal. Has no one told these people to never mess with a smart, determined person with little to lose?! [...]
