Aetna denied PET Scan

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pinkpal57
pinkpal57 Member Posts: 2
A biopsy recently confirmed recurrence of stage 3 breast cancer that I originally had in both breasts and all lymph nodes seven years ago. So my oncologist ordered a PET scan to determine the locations of the returned cancer before I see the surgeon next week. Aetna has denied authorization for this scan. These greedy insurance companies should be cited for denying exactly what well-meaning patients are paying them for, especially in a recurring disease. I don't know how their employees can lay their heads down at night and sleep knowing they are denying required procedures for cancer patients. After a peer to peer review between my Dr. and theirs, they did authorize a CT scan. Any suggestions for appealing, or just some plain old words of encouragement. I want to know where the metastis has occurred and understand the PET is better for this. I am pretty much alone in this. As if we are not already worried enough...... Any information or support would be greatly appreciated! I am treating at UPMC's Magee Women's Hospital in Pittsburgh, PA.
Heartfelt thanks

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  • Meme14470
    Meme14470 Member Posts: 30 Member
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    I'm not sure how true this is

    I'm not sure how true this is but i read this and it might be worth a try.....

  • bonbondidit
    bonbondidit Member Posts: 116
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    Denied PET scan

    UGH! I concur with what Meme stated. Also, I would ask for a gadolinium mri scan. The dye should stick to cancer cells and light up for the MRI pic.

    Force it!

    Bonbon

  • twnkltoz
    twnkltoz Member Posts: 169 Member
    edited July 2016 #4
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    Appeal it!

    So sorry you're going through this. I'm on medi-cal, and they tried to deny paying for my PET scan. I asked the doctor to appeal it for me, they did, and it was paid. I think sometimes they hope you'll just roll over and accept it, but when your doctor says it's medically necessary they have to pay it. 

    Definitely greedy bastards...don't let them get away with it.