Thursday, December 20, 2007

Going for the clinical trial

I've opted for the clinical trial, though I still haven't received precertification from the insurance company. This morning I was summoned to the hospital on an hour's notice to meet with the radiation oncologist, a direct, fairly blunt woman who informed me that the radiation is going to cause impaired lung function, so don't come to her in two years' time complaining that she didn't tell me. I like her nonetheless.

She wants to "map" me right away and made an appointment for a special type of CT scan for 8 tomorrow morning. I told her I wasn't precertified. She said to sit tight and she'd contact the oncology nurse who is allegedly handling precert. A half hour later or so the radiation doc told me I AM precertified, and her minions proceeded to do what they do. When I returned home, I decided to check w. the oncology nurse, who told me I'm certified for CHEMO, not RADIATION. This led to half an hour on the phone w the insurance company, which told me I am NOT certified for chemo, certification is PENDING receipt of clinical info from the hospital and authorization by an insurance nurse. They also told me precertification is NOT required for radiation therapy, despite the fact that last week they told me it IS required.

On the bright side, the hospital faxed the form that allows me to authorize my cousins to access my medical records, so THEY can deal with the insurance company on my behalf. I am still awaiting the forms I requested several days ago from the insurance company that will authorize my cousins to represent me.

I do not yet know when treatment will start, but the sooner the better if you ask me. I can feel this thing progressing.

2 comments:

Anonymous said...

Valjean, our health care "system" is unbelievable. Whether it's radiation, chemo or getting your wisdom teeth out, no one wants to make it easy. If having an illness doesn't make you feel sick, dealing with an insurance company or HMO sure will.

So let's put this to good use. Just tap into the way you feel about the Kafkaesque nightmare that is this country's health care and insurance system, channel that wrath and desire for change toward the cancer cells ... visualize the encounter, and when you're done, there will be nothing left of those bad boys but a smoking heap. They gone.

You will prevail, indeed. It's that inner Polish cleaning lady.
Love you and so appreciate these updates. Your energy is powerful. Bets

René said...

Valjean, would you care to be specific and name the "insurance company"? The good or the ill that they do should not be hidden by anonymity.

I watched "Sicko" on DVD last night. And today there was a news item about a family that is suing CIGNA because they dithered so long before authorizing payment for a liver transplant for their daughter that by the time they authorized it she had become too sick and she died.

Insurance companies have got to be worried about the publicity, about the increasing apparence that they are somewhat less useful than tits on a boar hog (excuse the harkening to my rural roots). If the link to your blog were sent to muckamucks at your insurance company, they could follow your blog to see how well their company acquits itself. And think of the potential effect on the jury pool for the girl who needed the liver if the link gets broadly distributed -- CIGNA claims this case was a rare aberration.