**due to Megan not being good at technology this is a post from 8/18**
Alright. So. You go see your doc, right? And they say something is wrong. In order to find out what it is your doctor says you need a CT Scan. What happens next?
They send paperwork to your insurance provider. A doctor who works for your insurance company then reviews all of the clinical information & either approves or denies the request, based on criteria that your insurance company has deemed necessary for qualifying for insurance to cover (part) of the costs of the scan.
I’ve been denied twice in the last week or so.
Cuz the clinical information that was sent to my insurance provider just didn’t cut it. Monitoring tumor size in a stage four cancer patient just isn’t worthy…
So now it goes to a “peer to peer” review. I’ve had to ask Dr. Finn (or perhaps his assistant, Dr. Kim) to take time out of his busy schedule to sit on some call with someone to convince them that I do, in fact, need a CT scan. Cuz I have stage four cancer. And we need to keep an eye on it. Cuz. It’s. Cancer.
If it gets denied during that round then it will be escalated enough that my Case Management Nurse can step in, but her hands are tied until that happens.
I’ve pushed my scan & follow up appointment back 2 weeks to give this time to be sorted out. Which means 2 weeks more of waiting to make plans and book flights and dream about the fun I can have until my next appointment (which we’re super hoping he’ll say will be another 6 months away!).
Thanks, American Health”care” System. You’re a real gem.