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question about first follow-up appt after treatment

StruTanToot
Posts: 108
Joined: Aug 2012

Dear friends...I hope everyone had a wonderful Thanksgiving.

I have my first follow-up appointments after treatment in December. I am scheduled for a PET scan and will see the radiation and chemo oncologists and the surgeon.

A couple of questions...

First of all, can anyone tell me what to expect? I imagine I need to be prepared for some invasive procedures/exams.

Secondly, my insurance pays 100% if the procedure is pre-authorized (done by hospital) or if I pre-notify (done by me) the insurance company. The problem is that I'm not always sure what needs to be done for which procedure. For example, one would think a CT scan would require pre-authorization. Come to find out that my insurance doesn't require pre-authorization, but requires pre-notification.

My plan is to make sure I pre-notify on everything.

So...the question is...do these docs do any other procedures that might require a pre-notification or authorization other than the PET scan? I plan to pre-notify my insurance and to make sure the hospital gets pre-authorization for any procedure just to be on the safe side.

Thank you for any information, and most of all, I wish each and everyone of you a happy holiday season.

Angela_K
Posts: 374
Joined: Jan 2011

Question 1) PET scan turnaround varies from day to day and facility to facility. I mentioned to my PET tech person that I was there from out of town and it was my first follow-up scan to treatment and to please try to push the radiologist to read it before my appt two hours later that afternoon. She did and the report was there for my med onc to read. My med onc did not do an exam since the PET was clean. My rad onc did a very gentle DRE and a visual to again check skin healing. My surgeon did an anoscopy with absolutely no pain, just a little pressure.

Question 2) This day and age most, if not all, health care facilities are super diligent in doing their own pre-auths to insure they get paid. They have a specific employee(s) that verify benefits and get pre-auths all day. Mine won't even schedule the procedure until it's first cleared by the insurance company. Just ask your doctor's office how they do that. Bet you they have a policy and procedure for pre-authorization in place.

I know you're first follow-up will be just fine. You will always remember the moment in that first follow-up when your doctor tells you it's all good! Blessings to you!

lizdeli's picture
lizdeli
Posts: 521
Joined: Jul 2009

Stu
I mirror what Angela has said. For me the hardest part of the first follow up was the anxiety. I was very nervous and then extremely relieved after I got the good news. You have many reasons to expect good news. The waiting was the most painful thing for me. After the chemo and radiation, the follow up tests didn't physically bother me that much. Of course I was initially very embarassed about baring my "bun" to a plethora of doctors and medical students (MD Anderson is a teaching hospital). At times I had three students "observing". After 3 years I'm grown used to baring it and Im even considering getting a "smiley" tatoo on my butt just for fun!

Wishing you well. Do whatever you need to do to stay as calm as possible until your exams. It's not easy, I know. But the sense of relief afer getting the good news is like the weight of world has been lifted off your shoulders.
I'll be saying a prayer for you.
Liz

Marynb
Posts: 1134
Joined: Aug 2012

Hi. Good luck on your first follow up. I did not have a scan. The hospital I am treated at does not use scans for follow up. I ma really starting to question that, as it seems everyone else has scans.

I called my insurance company during treatment and they assigned a nurse to make sure everything was authorized. You might want to call your insurance company to discuss possible testing.

You are in my prayers and I am so glad that you are dong well!

mp327's picture
mp327
Posts: 2889
Joined: Jan 2010

I was very nervous about my first follow-up with my colorectal doc, but she was very gentle and I had no pain, perhaps just a little discomfort.

My suggestion to you regarding the insurance coverage is to do your best to find out ahead of time what tests and exams your doctor will be doing and call your insurance company to find out what exactly is required in order for the charges to be pain, such as pre-certification, pre-notification, etc. Most medical facilities will take care of all the pre-certs, etc., but it's always a good idea for the patient to also contact the ins. co. to make sure there are no snags. Also, be sure to ask the ins. co. what date or range of dates any pre-cert is good for. I had an experience once where the ins. had the wrong dates and the actual date of the scan was not within that range. I got it straightened out ahead of time because of my phone call to the ins. co. just to make sure all ducks were in a row. I have found that my hospital is very good about calling to get things pre-certified, as they don't want to get stuck with charges that the patient won't pay.

I wish you all the best with the upcoming follow-ups and I'm sure all the news will be good!

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