Monday, April 28, 2008
Well, we got an answer ...
Not the one we wanted, though. I got a letter in the mail today with a denial for the SIR Sphere procedure with the reason given that the procedure is "unproven". So now we have to submit an appeal, and once we submit the paperwork for the appeal, they have 72 hrs. to answer. So tonight we are putting together a comprehensive history of all treatments and scans related to the liver tumor(s) to support our request for treatment. Seems like the doctors would have done that already, but if you want something done right, you have to do it yourself. We hope that the appeal will be submitted tomorrow so that we'll have an answer by Friday. I think I will go crazy if I have to wait over another weekend to hear if I can get this treatment! It's been seven weeks since my last chemo (I was due for my next treatment four weeks ago), so I don't feel like I can wait around too much longer. We may have to give up on this and just get the chemoembolization so that I can get started on systemic treatment again. It's just so frustrating that some nameless person at an insurance company, who has never seen me, gets to decide whether I can try this treatment that three of my doctors are recommending as the best course for me to take!
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6 comments:
Sarah, I am so sorry about this, it is infuriating and extremely disappointing. I know you guys will put together a good appeal, and I'll be pulling hard for them to listen. Hang in there, this situation is so unfair. you bear that with such grace. - Sharon
Sarah,
I'm sorry that the insurance was denied. If you need help with the appeal, please let me know. I've assisted with a good many and have supporting documentation that might be helpful (abstracts, papers, efficacy information). You can reach me by email at rslindley@aol.com or phone 903-275-4321.
Good luck!!! Sending prayers for a positive appeal.
Suzanne
So sorry. I've had experience with insurance appeals and it can be grueling but it's so worth it. I really think that they deny things just to see if people will fuss or not. Take help where you can, and throw as much info at them as you can. We'll be sending many good thoughts your way!
How mad you must be! I get so mad about insurance and medical bills over much, much, much more trivial mistakes they make. I'm rooting for you. I hope the appeal works!
I'm sorry to hear about the latest glitch; that is maddening. I know you will continue to fight your hardest for the treatment your doctors recommend. Relax when you are able. We continue to pray for your recovery.
Paige and Trey
Incredible that can be withheld ... I hope that you have made progress since then.
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