Just wondering if anyone else has had this problem. My sister had a consultation with a oral head and neck surgeon who scheduled her surgery date for June 2. We ar having an issue with the primary dr sending in all the information she needs for the referal. So as of now not even the consultation is covered. Has this happened to anyone? How could I get this dr who already mis diagnosed her for 7 months to get this referal in. I can not even tell you how frustrating this has become. No one with cancer should ever have to go through this! How could you let a person with this devestating disease beg for their surgery. Any help would be much appreciated. Thanks!!

Awful! I am so sorry. I wa smisdiagnosed too and was told I'd have to pay several hundred dollars to go to an ENT without a referral. The system is very frustrating.

I would go an sit in his office and demand that he write the referral letter immediately or he will be talking to your lawyer (even if you don't actually have one). His incomepetancy is causing delay in your sisters treatment and financial duress on all of you.

What a total jerk! Like you need this on top of it all.

Thinking of you.

K

Hoep you

I would also ask the surgeon's office to go after the referral. They may have better luck. After that, I too would go sit in the docs office (or call every hour) till one was written.
All the best,
Rob

What you need a referral to is a multidisciplinary team. A surgeon may not be your first path of attack, and you need a team including chemo and radiation doc to decide what should be done. But if this guy is part of a delay, he is liable for the consequences of that delay, such as the disease progressing to a more advanced stage, the additional damage done to her by more aggressive treatments dictated by that more advanced disease, and more.....

You can self refer to a multidisciplinary institution. They will reach back to him for the information, and those institutions are very unforgiving of delays in getting a response.

I ditto to what the others have already suggested.

I had difficulties at first with my primary. We then got a personal nurse coordinator that our insurance provided that helped get things in order for us. We were all on 3 way phone call to get things straightened out but I still had to make frequent calls to make sure things were getting done.

Hopefully your primary will get things going for you, it's a shame they are blowing you guys off!

Thanks everyone for the help!! My mother and I actually went to the primary's office with a patient care activist(our friend) and would not leave without the referal number. We called the health insurance the day before and they told us that they were trying to call the primary for some answers about Some things for 2 weeks and he didn't call back. This is so nice of this dr to do after he mis diagnosed my sister for 7 months but that's beside the Point. After our little scene at his office we walked out with 6 visits approved to the head and neck surgeon. Whew!!!
Brian- thanks for the advice on the multidisciplinary team!! We are using that and have called them about out issues and now that they have the referal on the visit they will proceed with everything we need now. Thank goodness!! I am so thankful that my sister has a wonderful support group. I can not imagine a person that has cancer and really doesn't have a family going through the paperwork and aggrevation that comes along with it.
Her surgery is now scheduled for June 2. I am soooo worried about it but I'm trying to take it day by day!! Thinking in the future is just to hard with all the what it's. Thanks everyone again for your help on just another hill that we overcame!!

Im glad you got everything covered. This has me wondering -and maybe someone else here can answer for me. I just made an appointment at DUke CCC without a referral. Will this cost us more?

It shouldn't. My husband's initial biopsy of a leukoplakia showed only moderate dysplasia, so he had the whole thing removed by a general ENT in northern Virginia since cancer was not indicated.

When that pathology report came back positive for SCC in situ, my husband made a follow-up appointment at Hopkins himself, without a referral. Hopkins was on our insurance (we live about a hour from Baltimore) and all he had to pay was the standard co-pay for a specialist visit.

Whether a referral is needed may depend more on your mom's insurance plan than anything else. We have a PPO with no referral necessary. If her plan is a HMO, then a referral may be required. Either she or you should check.

Shes on BCBS PPO so hopefully it shouldnt be a problem. Thank you!

If you want to double-check, call the appointments people at Duke. They should know, or will be able to connect you with people there who do.

Yes Duke should be able to tell you exactly what you will need. Our surgeon knew what we needed..Good Luck!