PET Scan

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KTeacher
KTeacher Member Posts: 1,103
in Head and Neck Cancer #1

Insurance denied PET Scan for next week, MRI is still on.  I guess that makes for less scanxiety, Not!  Nurse did say MRI would show any problems in head (Matt, John, behave yourselves!)

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  • CivilMatt
    CivilMatt Member Posts: 4,722 Member
    #2
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    see anything?

    Bev,

    So you miss infusion with radioactive material and substitute someone banging on your head, sounds like an all-around good plan.  Now what they will see are (most desirably) good things and no problems at all.

    Best,

    Matt

  • longtermsurvivor
    longtermsurvivor Member Posts: 1,842 Member
    #3
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    Hi Bev

    Given your history of regional recurrances, the MRI should be a very acceptable test.  Best of luck to you.  Sheesh.  this truly is another case of an insurance company practicing medicine without a license.  If an individual does that, they go to jail:)

     

    pat

  • KTeacher
    KTeacher Member Posts: 1,103
    #4
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    longtermsurvivor said:

    Hi Bev

    Given your history of regional recurrances, the MRI should be a very acceptable test.  Best of luck to you.  Sheesh.  this truly is another case of an insurance company practicing medicine without a license.  If an individual does that, they go to jail:)

     

    pat

    Thank you

    Thank you.  My husband is fuming.  He has been on the phone but I knew how it would turn out.  BCBS contracts out to another group to approve/deny.  That group will not talk to the patient, just the doctor. 

  • longtermsurvivor
    longtermsurvivor Member Posts: 1,842 Member
    #5
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    KTeacher said:

    Thank you

    Thank you.  My husband is fuming.  He has been on the phone but I knew how it would turn out.  BCBS contracts out to another group to approve/deny.  That group will not talk to the patient, just the doctor. 

    I understand his fuming over this

    but honestly, pick your battles carefully and don't waste time and emotion on this one.  I have gone the route of CT for follow up.  In my situation it is good enough, and my issues have lots of things more important than getting into long, taxing squables over the scans.  Under other circumstances I would feel differently.    And yes, these deals where they will only talk to the attending physician add another layer of heartache to this.  Some physicians take this personally.  I did in my practice and I never lost an appeal.  Other doctors don't want to take up their time with this.  It really creates an artificial level of stratification for follow up testing.   Your MRI has great fidelity, down to the millimeter size, and for you, Bev, may actually be better than a PET scan.  The PET won't be positive for lesions this small.  Not claiming to have all the answers to this, because I don't.  But neither do these insurance companies, they are denying based upon cost, and an algorithm that is designed to lower it.  Nothing more.

     

    Pat

  • debbiejeanne
    debbiejeanne Member Posts: 3,102 Member
    #6
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    bev, i'm sorry to hear that

    bev, i'm sorry to hear that but at least Pat feels the MRI should be even better.  i'm sure you will be fine but I'm saying a prayer for you as insurance.  let us know how you do. 

    God bless you,

    dj

  • Hondo
    Hondo Member Posts: 6,636 Member
    #7
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    Hi Teacher

    Insurance; like what do they know, my ENT wanted to do a PET but said the insurance might say no, so we opt to do a CT first just to take a look and see if a MRI or PET will be needed.

    Well Oh; is all we can do, will keep you in prayer on your MRI

     

    Tim Hondo

  • phrannie51
    phrannie51 Member Posts: 4,716
    #8
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    KT....I haven't had a PET scan

    since 3 months out of treatment.....only MRI's with and without contrast.  In the beginning this made me nervous as hell, but an MRI seems to be acceptable even to my oncologist who I feel has always been there to protect me.

    You're right tho....scanxiety does not diminish as the cost of the scan goes down....at all!!  Wish I could hold your hand in person for the next few days....tho we'd both be holding on as we sat on the ceiling fan :).

    p

  • hwt
    hwt Member Posts: 2,328 Member
    #9
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    phrannie51 said:

    KT....I haven't had a PET scan

    since 3 months out of treatment.....only MRI's with and without contrast.  In the beginning this made me nervous as hell, but an MRI seems to be acceptable even to my oncologist who I feel has always been there to protect me.

    You're right tho....scanxiety does not diminish as the cost of the scan goes down....at all!!  Wish I could hold your hand in person for the next few days....tho we'd both be holding on as we sat on the ceiling fan :).

    p

    Bev

    Prayers for good results on your scan. I hope you get a much deserved good report.

     

  • Goyca
    Goyca Member Posts: 220
    #10
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    Good luck Bev. Keep us

    Good luck Bev. Keep us updated.

     

    sending u hugs.

    Goyca.

  • ratface
    ratface Member Posts: 1,337 Member
    #11
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    Been down this Insurance road

    I'm sorry you are experiencing this treatment with BCBS. The name of their hired gun is, "Telligen" and their behavior surpasses criminal conduct for sure. It is my suspicion that they initially deny every single request. They just wear you out with protocol. Consider the fact that many head and neck folks can't really converse well on a telephone because of treatment. I've gotten letters from Telligen on the same day, one denying and another approving the same CT scan. You just want to bang your head against concrete. Their appeal process is akin to slowly having your fingernails pulled out.  Your husband is a warrior for dealing with these criminals. My intention is not for you to fret over this but just to know that they treat everyone like crap. Par for the course but good luck with the MRI!

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