OK I want to go to Dana Farber in Boston for a second opinion on Radiation . But I need a prior approval(out of network) , any ideas on how to go about this ( besides callin them ) What kind of information will I personally need to give Ins co. and what do you think the wait time on this approval is , I have MVP if anyone is familar with it > I used to do Ins billing for Planned Parenthood . But we didnt do Prior approvals so really unfamilar with this.

I had to get prior approval last year to see a radiation oncologist at Ohio State even though they were in the Humana network - they were out of the "Cincinnati" Humana network. I had to get letters written by both my surgeon and my general practice doctor. I also had to make several phone calls and yell and throw a fit. It was really a pain. The office told me that if I didn't get it approved BEFORE the visit - that likely the insurance wouldn't pay - and since it was inside the hostpial at OSU - it would be about $500 or more for the consult (and they also read my slides so it was really more than that). They ended up approving it - but it took a good week or two.

I now have a different plan with a different company which has a wonderful cancer resources network. Call your company and see if they have a specific line for cancer related issues. If they do - this is the best way to proceed.

Good luck.