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Insurance Denied IMRT

howdybooth
Posts: 44
Joined: Aug 2009

My sister's insurance - Aetna - denied her rad/onc prescription for IMRT since her cancer is listed as Stage 1B Grade 2. Nice! The radiologist doesn't feel that her cancer is acting like a stage 1B and has sent slide to MD Anderson Cancer Center in Houston to review her path. Has anyone else had to fight the insurance company on this and won? Also, what do they (the ins. company) have in place that allows them to over rule a doctor's orders? Are they practicing medicine without a license in the state of Texas? Don't get it at all! She can't have more surgery or very strong Chemo because of her heart and radiation is basically her only choice! Frustrating that you have to fight the cancer and the insurance!

Songflower's picture
Songflower
Posts: 632
Joined: Apr 2009

Get a lawyer and fight them. Write a letter about what you just wrote. Fight now.

nursey420's picture
nursey420
Posts: 53
Joined: Mar 2009

Have your doctor write a letter to the insurance company and enclose your medical records. Make sure t states this is not optioinal and that it will defer further treatment hence less costly in the long run. Godd luck and don't stop fighting
Lisa

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