Just reviewing belatedly the changes to my Federal Blue Cross/Blue Shield insurance and this one is a doozy: effective jan 1, 2010, all IMRT outpatient TX must receive PRIOR approval. The explanation is that BC/BS FEP needs to be sure that IMRT TX is medically necessary. I find it hard to believe that anyone is getting IMRT as a lark or as a cosmetic or dietary measure. Previously you never needed advance or prior approval, just a radiation oncologist order. One more insult and indignity for oral cancer patients and at a minimum, needless delay. Glad my IMRT and Cyberknife TX were in 2007 and 2009 before this policy change. Charm
65 yr Old Frack Stage IV BOT T3N2M0 HPV 16+ 2007:72GY IMRT(40) 8 ERBITUX No PEG 2008:CANCER BACK Salvage Surgery 25GY-CyberKnife(5) 3 Carboplatin Apaghia /G button 2012: CANCER BACK -left tonsilar fossa 40GY-CyberKnife(5) 3 Carboplatin