Denied cat scan

rdoyd2
rdoyd2 Member Posts: 80 Member
in Kidney Cancer #1

I had scans every 6 months for two years, so I had the one that diagnosed it then one I think a month after my neph and then I had them every six months, so I had 6 total up to that point. then we went to every year. I had that first yearly scan last year.   I was supposed to have my yearly scan next week but Aetna refused it said I could have ultrasound and X-ray. My doc said that we would do yearly scans till I reached 5 years out then we would alternate with the ultrasounds every year. This is  my fourth year scan so I quess next year I will have the cat scan. Should I complain and try to force the cat scan or just go with it. 

Comments

  • icemantoo
    icemantoo Member Posts: 3,361 Member
    #2
    Fight back

    rdoyd2,

     

    Fight back as Aetna is currently getting a lot of bad publicity on its medical reviews. Will your doctor join you with this fight?

     

    Icemantoo

  • rdoyd2
    rdoyd2 Member Posts: 80 Member
    edited February 2018 #3
    I dont know yet , just found

    I dont know yet , just found out yesterday going to talk to him later today. Has anyone else had this problem? I thought it was normal to have yearly scans for 5 years?

  • Trinityo88
    Trinityo88 Member Posts: 22
    #4
    scans

    I am due to have a robotic partial neph soon hopefully.  When my doctor told me about the after care plan he said 3 years of scans and 5 years of blood tests.  I have read several articles and have heard both versions.  Not sure which is right or which is wrong.  Fight for what you think is right for you!

  • ImNotDeadYet
    ImNotDeadYet Member Posts: 244
    #5
    Definitely question and fight

    We have to become advocates for ourselves, sometimes with our doctors and sometimes with the insurance companies. And as IcemanToo said, Aetna is in hot water right now for decisions such as this. Probably a good time to appeal this one, especially if your doctor will support you with it. Good luck!

  • Hd67xlch
    Hd67xlch Member Posts: 151 Member
    edited February 2018 #6
    Fight for your scans............

    My wife has Aetna and she always gets denied scans and has to appeal them. You need to press the issue, it was on my 5 year ct scans they found that my rcc had returned and metastiszed. Good luck

  • rdoyd2
    rdoyd2 Member Posts: 80 Member
    #7
    Talked with doc , he says he

    Talked with doc , he says he is ok with ultrasound and X-ray this year 

  • rdoyd2
    rdoyd2 Member Posts: 80 Member
    #8
    next year I will get cat scan

    next year I will get cat scan, from now on I will alternate every year. Doc says because im a chromie and had no sarcomatoid or necrosis that I'm low risk. My tumor was 11.7 cm. I was stage two. I trust my doc so if he says I alternate every year I will. 

  • foxhd
    foxhd Member Posts: 3,181 Member
    edited February 2018 #9
    Fight it.

    I have a $100 that says your doc would not accept xray and US if it was him or his family. Be your own advocate. I doubt they can show you a dated protocol saying CT scan is not indicated.

    Make the phone call. Insist on speaking to supervisors. Ins. co. have a practice of denial without proper review. Aetna has been caught and exposed.

    The biggest mistake you will ever have a chance to make is not being a squeeky wheel. Any weakness in your aggressiveness will be taken advantage off. They care nothing about you. You are a chart number. Nothing more. Don't accept it.

  • stub1969
    stub1969 Member Posts: 978 Member
    #10
    Words of wisdom

    You are getting good advice, but one we should all listen to is the latest post by Fox.  He is right on with his advice!

    Good luck!

    Stub

  • rdoyd2
    rdoyd2 Member Posts: 80 Member
    edited February 2018 #11
    i was going to start

    i was going to start alternating after my 5 year scan any way . I didn't like it but that's what doc said was required .  Doc said he's fine with it so he won't press it. I think I should have scans at least this year and next year then start alternating I quess.

  • rdoyd2
    rdoyd2 Member Posts: 80 Member
    #12
    Should I get scans every year

    Should I get scans every year for life or is there a time when we start alternating ?

  • rdoyd2
    rdoyd2 Member Posts: 80 Member
    #13
    Fox your right ! I'm going to

    Fox your right ! I'm going to force the  issue. Hd thanks for your input I'm glad your doing well now. That must have been a schock 

  • Retcenturion
    Retcenturion Member Posts: 240 Member
    #14
    A national guide

    My doctor is following the National Comprehensive cancer Network Guidelines for kidney cancer. Follow up an category 2b. Baseline CAT or MRI , then CAT ,MRI, or ultrasound 3to 6 months for at least 3 yrs then annually up to 5. Check it out . It explains for me what I will be following. You have nothing to lose by asking for the procedure. You become an annoyance to someone who doesn't know you so what. You've earned the right to be listened to at the minimum.

  • todd121
    todd121 Member Posts: 1,448 Member
    edited February 2018 #15
    Fight It

    And 5 years is a **** cutoff date. There's no data to support stopping at 5 years with RCC. They are taking data from other cancers which have data to support stopping at 5 years and applying it to RCC.

    If you need to, find another doctor and get another opinion.

    Perhaps you feel some pain in your side? If I had to, I'd go with that approach. Lol. I'm serious here. I would insist on annual CT scans chest/abdomen and pelvis even after 5 years. I'd pay out of pocket even to get them, but I'd definitely push them in any way I can. You want to catch anthing early. If you wait for symptoms to show up, it will very likely not be something operable by the time symptoms show up.

    Todd

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