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When Doctors and Insurance Comp. Take Away Your Cancer Treatments

When Doctors and Insurance Comp. Take Away Your Cancer Treatments…

As I sit here writing this I am left to wonder what am I going to do. About a month ago I went to see another oncologist in hopes of getting a fresh outlook on my care and maybe a chance to convince him I need to see a specialist. Well that went very badly and I documented it in my previous post  Giving up is NOT an Option Feel free to go back and read it to catch up.

Anyway, since that went to badly I filed a complaint with my insurance in hopes of being able to talk to them and show them information as to why I need to be seen by a specialist. See this is not just a want at this point. My insurance does not have doctors with the knowledge or the testing capabilities I needed to properly see what is going on with me.

  • Where did it happen?
  • What was my complaint about?
  • How I do I want it solved?

Well that was harmless enough. Except it only gives you 4,000 characters in each field for each question. I did my best to put all the facts thinking maybe I could fill in the rest with someone later.

WOW was I wrong!!

I got a phone call back a day later from Cynthia. She informed me that she was submitting my complaint to one of their doctors, and he would decide by the following day if I needed to be seen by a specialist. I asked her if I could speak with this “doctor” because there was a lot of information he would need to be able to make that determination. After all, this is a rare cancer and unless you are familiar with my case there is no way he can make an informed decision in less than 24 hours. She told me I could not speak with him or get his name.

At this point my life is in the hands of someone who has never seen me before, and has no prior knowledge of my case. I am seriously wondering how this is even possible…. I can tell you it is not. I got a phone call back late the next morning from the same lady. She tells me that this doctor has denied my request sighting that the insurance company has everything I need and can take care of all of my needs.

In the back of my mind I already knew this was going to happen. I have been denied before. Last time they told me it would not make any difference in my out come so they did not see a need.

I asked this lady what my next step was because I did not agree with this doctor. She told me she could resubmit it to another doctor and get back to me by weekends end.

My husband was the one who took the call. This time was from Eddie. My husband told him I was not available. Eddie proceeded to tell my husband all about the decision. Mind you he did not verify whom he was talking to or if he had my approval to get this information from him. He gave my husband details about my case that were quite sensitive. What this guy did was a breach of HIPPA laws and my husband called him on it. We will be addressing this matter as well.

Anyway, I was turned down a third time now. I am going to have to get a lawyer and go through arbitration at this point. This is not the worst part though.

I called the oncology scheduler to get my next two sandostatin injections set up and was told she could not do this. There was a note from the on call oncologist that said I had to wait until my oncologist came back to discus if I will be getting them at all.  I get these injections every 14 days and have for 4 years now. My oncologist will not return until after the 19th.  This will be several days after I am due for my next injection.

My oncologist has threatened to take way the only medication that keeps my carcinoid syndrome symptoms from making me too sick. However he has never actually done it.  I am terrified that if I cannot get the injections I will be sick and maybe even in hospital by the holidays.

I am not happy about this. The thought of it is honestly making me ill. I don’t know what is going to happen next. I really don’t want to do this. I don’t need the stress or anxiety of a legal battle. I especially don’t want a battle with a huge insurance company.

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3 responses to “When Doctors and Insurance Comp. Take Away Your Cancer Treatments

  1. I’m speechless! I don’t even know what to say… this is so wrong one very level. All I can think of is I AM SO SORRY and angry that you have to go through this crap. ARGH!

  2. Marcia Johnson

    This is so awful! I am so sorry to learn this. So another holiday trying to cope. Keep complaining!! the squeaky wheel gets greased.