Previous Thread
Next Thread
Print Thread
Page 10 of 12 1 2 8 9 10 11 12
Joined: Oct 2013
Posts: 58
Supporting Member (50+ posts)
OP Offline
Supporting Member (50+ posts)

Joined: Oct 2013
Posts: 58
My hmo denied my chemo treatment even though 2 cancer centers agree I should. Very annoyed with the system but I will win.


8/2013 dx sarcoma lft mandible 10/22/2013 fibula free flap with mandiblectomy, peg,tracheotomy, 11/8/13 trach removal, 2nd mandible sx 12/13, 35 IMRT 1/2014.4/2014 chemo x6 only tolerated 3. (Seizures) repeat fibula free flap 1/2016
Joined: Jun 2007
Posts: 10,507
Likes: 2
Administrator, Director of Patient Support Services
Patient Advocate (old timer, 2000 posts)
Offline
Administrator, Director of Patient Support Services
Patient Advocate (old timer, 2000 posts)

Joined: Jun 2007
Posts: 10,507
Likes: 2
Appeal the denial. Your doc should help you by sending a letter of necessity to your insurance company.

Dont give up. Keep fighting.

Good luck!!!


Christine
SCC 6/15/07 L chk & by L molar both Stag I, age44
2x cispltn-35 IMRT end 9/27/07
-65 lbs in 2 mo, no caregvr
Clear PET 1/08
4/4/08 recur L chk Stag I
surg 4/16/08 clr marg
215 HBO dives
3/09 teeth out, trismus
7/2/09 recur, Stg IV
8/24/09 trach, ND, mandiblctmy
3wks medicly inducd coma
2 mo xtended hospital stay, ICU & burn unit
PICC line IV antibx 8 mo
10/4/10, 2/14/11 reconst surg
OC 3x in 3 years
very happy to be alive smile
Joined: Dec 2010
Posts: 5,260
"OCF Canuck"
Patient Advocate (old timer, 2000 posts)
Offline
"OCF Canuck"
Patient Advocate (old timer, 2000 posts)

Joined: Dec 2010
Posts: 5,260
Freak out!! Move to canada... Fight!!


Cheryl : Irritation - 2004 BX: 6/2008 : Inflam. BX: 12/10, DX: 12/10 : SCC - LS tongue well dif. T2N1M0. 2/11 hemigloss + recon. : PND - 40 nodes - 39 clear. 3/11 - 5/11 IMRT 33 + cis x2, PEG 3/28/11 - 5/19/11 3 head, 2 chest scans - clear(fingers crossed) HPV-, No smoke, drink, or drugs, Vegan
Joined: Oct 2013
Posts: 58
Supporting Member (50+ posts)
OP Offline
Supporting Member (50+ posts)

Joined: Oct 2013
Posts: 58
Having my 3rd opinion on Friday ( the tie breaker) today I had 4 ct scans and a bone scan....(my pre-ops for chemo) my hmo will pay for those but not chemo.....go figure! Completely frustrated.


8/2013 dx sarcoma lft mandible 10/22/2013 fibula free flap with mandiblectomy, peg,tracheotomy, 11/8/13 trach removal, 2nd mandible sx 12/13, 35 IMRT 1/2014.4/2014 chemo x6 only tolerated 3. (Seizures) repeat fibula free flap 1/2016
Joined: Dec 2010
Posts: 5,260
"OCF Canuck"
Patient Advocate (old timer, 2000 posts)
Offline
"OCF Canuck"
Patient Advocate (old timer, 2000 posts)

Joined: Dec 2010
Posts: 5,260
Bomb threat?


Cheryl : Irritation - 2004 BX: 6/2008 : Inflam. BX: 12/10, DX: 12/10 : SCC - LS tongue well dif. T2N1M0. 2/11 hemigloss + recon. : PND - 40 nodes - 39 clear. 3/11 - 5/11 IMRT 33 + cis x2, PEG 3/28/11 - 5/19/11 3 head, 2 chest scans - clear(fingers crossed) HPV-, No smoke, drink, or drugs, Vegan
Joined: Oct 2013
Posts: 58
Supporting Member (50+ posts)
OP Offline
Supporting Member (50+ posts)

Joined: Oct 2013
Posts: 58
Lol crossed my mind along with several other thoughts.


8/2013 dx sarcoma lft mandible 10/22/2013 fibula free flap with mandiblectomy, peg,tracheotomy, 11/8/13 trach removal, 2nd mandible sx 12/13, 35 IMRT 1/2014.4/2014 chemo x6 only tolerated 3. (Seizures) repeat fibula free flap 1/2016
Joined: Oct 2013
Posts: 58
Supporting Member (50+ posts)
OP Offline
Supporting Member (50+ posts)

Joined: Oct 2013
Posts: 58
Chemo won. 6 cycles here I come....


8/2013 dx sarcoma lft mandible 10/22/2013 fibula free flap with mandiblectomy, peg,tracheotomy, 11/8/13 trach removal, 2nd mandible sx 12/13, 35 IMRT 1/2014.4/2014 chemo x6 only tolerated 3. (Seizures) repeat fibula free flap 1/2016
Joined: Dec 2010
Posts: 5,260
"OCF Canuck"
Patient Advocate (old timer, 2000 posts)
Offline
"OCF Canuck"
Patient Advocate (old timer, 2000 posts)

Joined: Dec 2010
Posts: 5,260
WOOOOT... well okay.. YAY?

I guess this is where the "be careful what you ask for" saying comes into play.

Sorry not trying to be facetious. I am very glad you got the insurance company to concede. Chemo runs the gamut, to no more bothersome than a fly, to head in bucket sick for the entire time. For me it didn't really bother me at all other than mild nausea. Most people sit somewhere in the middle of the two extremes. But the one plus is that it makes the rads more effective so it's worth whatever you have to go through.

hugs!!!!



Cheryl : Irritation - 2004 BX: 6/2008 : Inflam. BX: 12/10, DX: 12/10 : SCC - LS tongue well dif. T2N1M0. 2/11 hemigloss + recon. : PND - 40 nodes - 39 clear. 3/11 - 5/11 IMRT 33 + cis x2, PEG 3/28/11 - 5/19/11 3 head, 2 chest scans - clear(fingers crossed) HPV-, No smoke, drink, or drugs, Vegan
Joined: Oct 2013
Posts: 58
Supporting Member (50+ posts)
OP Offline
Supporting Member (50+ posts)

Joined: Oct 2013
Posts: 58
My chemo delayed for a week. Infection in my chin. 3rd infection in as many months. What am I doing wrong?


8/2013 dx sarcoma lft mandible 10/22/2013 fibula free flap with mandiblectomy, peg,tracheotomy, 11/8/13 trach removal, 2nd mandible sx 12/13, 35 IMRT 1/2014.4/2014 chemo x6 only tolerated 3. (Seizures) repeat fibula free flap 1/2016
Joined: Dec 2010
Posts: 5,260
"OCF Canuck"
Patient Advocate (old timer, 2000 posts)
Offline
"OCF Canuck"
Patient Advocate (old timer, 2000 posts)

Joined: Dec 2010
Posts: 5,260
I had my chemo delayed as well - I was on three big bags though. It's normal to have issues. At this point you are already immunocompromised, chemo will make this worse and leave you open to infection. you had a pretty big surgery not too long ago so your body is likely still trying to heal and recoup still and now you are tossing another arsenal of meds and poisons at it.

hugs and stay strong.


Cheryl : Irritation - 2004 BX: 6/2008 : Inflam. BX: 12/10, DX: 12/10 : SCC - LS tongue well dif. T2N1M0. 2/11 hemigloss + recon. : PND - 40 nodes - 39 clear. 3/11 - 5/11 IMRT 33 + cis x2, PEG 3/28/11 - 5/19/11 3 head, 2 chest scans - clear(fingers crossed) HPV-, No smoke, drink, or drugs, Vegan
Page 10 of 12 1 2 8 9 10 11 12

Link Copied to Clipboard
Top Posters
ChristineB 10,507
davidcpa 8,311
Cheryld 5,260
EzJim 5,260
Brian Hill 4,829
Newest Members
jens, cAVEgIRL, IowaBlueJ, Nancy Jablonski, nlawson
12,902 Registered Users
Forum Statistics
Forums23
Topics18,048
Posts196,297
Members12,902
Most Online458
Jan 16th, 2020
OCF Awards

Great Nonprofit OCF 2021 Charity Navigator OCF Guidestar Charity OCF

Powered by UBB.threads™ PHP Forum Software 7.7.5