1/2 way there

tommaseena
tommaseena Member Posts: 1,769
edited March 2014 in Breast Cancer #1
I just finished my 6th does of Taxol w/Herceptin so I am half way there with the chemo treatments. I was told yesterday and last week that all I was getting was Herceptin because the order for Taxol was not in the computer. Well I set everyone straight on that and have now gotten the orders signed and updated so I won't have to go through this each and every time.

Everyone should keep track of their treatment plan and know what they are getting each and every time. Nurses can only do what is ordered by the oncologist so make sure your chart is always updated. You don't want to have more or less treatments than what was originally in the plan.

Be aware of everything--even what you pre-meds are.

Also always look at your Explanation of Benefits from your insurance company and if you have any questions call your insurance company and then call the billing or coding department to either have them research your charges or submit a corrected bill to your insurance company.

I also was told yesterday that I CAN'T have my office visit with my oncologist on the same day as chemo because some insurance companies don't pay for the office visit when done on the same day. My insurance company pays everything now at 100% until the new calendar year and then I start paying again. What ticks me off is with the cost of gas $2.70(here in Maine) and the travel and the time off from work they, the dr's office, should make some exceptions to their rules. When the new year comes then I will have to pay $30.00 for the office visit one day and then the next day pay $75.00 for the chemo visit and if they did it all in the same day then my co-pay would only be $30.00.

Sorry to vent but it really p i s s e s me off. I will take this up with my oncologist, her office manager and if I can't get any where there then the higher ups.

Margo

Comments

  • taleena
    taleena Member Posts: 1,612 Member
    #2
    Margo.. I just wanted to say
    Margo.. I just wanted to say thank you. Being new to all of this, I personally hadn't even thought that far. Haven't even met my onco yet. I guess blindly trusting that they get it right is pretty ignorant on my part. (Ignorant just means lacking knowledge.. and I do lack in this area).. I never even thought about looking at my medical benefits. The only thing I know about it is that I pay the first $5800.00 out of pocket, once that is hit they pick up 100%. That alone has been a big stress, also knowing that like you, once the new year hits, it resets again.

    I do know that for those of us who itemize on our taxes, that the mileage that we travel for medical purposes is also tax deductable. That is really the only thing that I can offer... Boy do I have some learning to do.

    Again thanks for venting and sharing.. making me stop and get my ducks in a row.

    ~T
  • dyaneb123
    dyaneb123 Member Posts: 950
    #3
    taleena said:

    Margo.. I just wanted to say
    Margo.. I just wanted to say thank you. Being new to all of this, I personally hadn't even thought that far. Haven't even met my onco yet. I guess blindly trusting that they get it right is pretty ignorant on my part. (Ignorant just means lacking knowledge.. and I do lack in this area).. I never even thought about looking at my medical benefits. The only thing I know about it is that I pay the first $5800.00 out of pocket, once that is hit they pick up 100%. That alone has been a big stress, also knowing that like you, once the new year hits, it resets again.

    I do know that for those of us who itemize on our taxes, that the mileage that we travel for medical purposes is also tax deductable. That is really the only thing that I can offer... Boy do I have some learning to do.

    Again thanks for venting and sharing.. making me stop and get my ducks in a row.

    ~T

    You go girl! Sounds like you
    You go girl! Sounds like you are on top of your treatment....something we should all do.
  • tommaseena
    tommaseena Member Posts: 1,769
    #4
    taleena said:

    Margo.. I just wanted to say
    Margo.. I just wanted to say thank you. Being new to all of this, I personally hadn't even thought that far. Haven't even met my onco yet. I guess blindly trusting that they get it right is pretty ignorant on my part. (Ignorant just means lacking knowledge.. and I do lack in this area).. I never even thought about looking at my medical benefits. The only thing I know about it is that I pay the first $5800.00 out of pocket, once that is hit they pick up 100%. That alone has been a big stress, also knowing that like you, once the new year hits, it resets again.

    I do know that for those of us who itemize on our taxes, that the mileage that we travel for medical purposes is also tax deductable. That is really the only thing that I can offer... Boy do I have some learning to do.

    Again thanks for venting and sharing.. making me stop and get my ducks in a row.

    ~T

    insurance
    You want to also check with your insurance company to see if there is a max that they pay out each year. I pay the first $5,000 out of pocket and then they pay 100% with no limit of what they pay per year. Each insurance company and policy is different. Some only pay $100,000 per year and then you have to pick up the rest even though you have met your out of pocket.

    I do have all my tolls and write down my mileage each and every time so I can use that at tax time.
  • taleena
    taleena Member Posts: 1,612 Member
    #5
    tommaseena said:

    insurance
    You want to also check with your insurance company to see if there is a max that they pay out each year. I pay the first $5,000 out of pocket and then they pay 100% with no limit of what they pay per year. Each insurance company and policy is different. Some only pay $100,000 per year and then you have to pick up the rest even though you have met your out of pocket.

    I do have all my tolls and write down my mileage each and every time so I can use that at tax time.

    ..do I really want to
    ..do I really want to look... okay.. maybe just peek... that just scares me!
  • Christmas Girl
    Christmas Girl Member Posts: 3,682 Member
    #6
    Congratulations for "1/2 Way There"
    Though I am sorry to learn of all the complications with records, billing, etc. ... Thanks for sharing your story here. A good reminder/warning to others, especially those just beginning or in the midst of it all.

    What particularly stands out to me is the ridiculous restriction by your insurance company - to deny the onc doctor office visit and chemo same day payouts. Yes, ticks me off, too. Because this is pretty much standard procedure for chemo patients. Which implies that it's just one of those restrictions to help save the insurance company money, and not based on anything else. Close monitoring (i.e., same day) by one's onc during chemo - any kind of chemo - is absolutely imperative.

    Kind regards, Susan

    P.S.: We always suffer the highest gas prices in the nation, now $3.00 around here, so I know what you mean...
  • gerrico1216
    gerrico1216 Member Posts: 41
    #7
    Call Insurance co.
    They tried that with me but I called my insurance company. Try that.
  • Kristin N
    Kristin N Member Posts: 1,968 Member
    #8
    Congratulations Margo on
    Congratulations Margo on being halfway done! That is so wonderful!

    I am sorry about your insurance company. Sometimes these insurance companies add so much more stress to our lives, that it just isn't fair. For anything expensive, MRI, ultrasounds, CAT scans, radiation treatments, I always called first and/or had the doctors call to make for sure that it was covered. I read where some people thought they would be covered and they weren't and got hit with a staggering bill and had no recourse.

    Good luck to you! Hugs, Kristin
  • tommaseena
    tommaseena Member Posts: 1,769
    #9
    Kristin N said:

    Congratulations Margo on
    Congratulations Margo on being halfway done! That is so wonderful!

    I am sorry about your insurance company. Sometimes these insurance companies add so much more stress to our lives, that it just isn't fair. For anything expensive, MRI, ultrasounds, CAT scans, radiation treatments, I always called first and/or had the doctors call to make for sure that it was covered. I read where some people thought they would be covered and they weren't and got hit with a staggering bill and had no recourse.

    Good luck to you! Hugs, Kristin

    It isn't my insurance
    It isn't my insurance company that is saying no it is other patient's insurance companies so those of us who have insurance that will pay everything after we reach out out of pocket are being put in the same boat. It isn't fair and I will be talking to the office manager and patient nurse navigator on Thursday so see if they can make exceptions to the office managers rule. I want to see this in writing and not just by word of mouth.

    If an insurance company pays then they should allow a patient to have a visit on the same day as their treatment.

    Margo
  • confused123
    confused123 Member Posts: 251
    #10
    tommaseena said:

    It isn't my insurance
    It isn't my insurance company that is saying no it is other patient's insurance companies so those of us who have insurance that will pay everything after we reach out out of pocket are being put in the same boat. It isn't fair and I will be talking to the office manager and patient nurse navigator on Thursday so see if they can make exceptions to the office managers rule. I want to see this in writing and not just by word of mouth.

    If an insurance company pays then they should allow a patient to have a visit on the same day as their treatment.

    Margo

    congrats on being half way
    congrats on being half way there!! I don't get not having the appointment the same day. Where I go I do bloodwork the day before and I see the doc right before chemo to find out if I can even get it based on my bloodwork results. Anyway we are neighbors if you are in Maine, I am in the great state of NH
    Kim
  • tommaseena
    tommaseena Member Posts: 1,769
    #11
    confused123 said:

    congrats on being half way
    congrats on being half way there!! I don't get not having the appointment the same day. Where I go I do bloodwork the day before and I see the doc right before chemo to find out if I can even get it based on my bloodwork results. Anyway we are neighbors if you are in Maine, I am in the great state of NH
    Kim

    Kim we are neighbors
    I am in Maine right outside the capital of Augusta. So we are neighbors.
    I have my bloodwork thru my port the day of chemo and see the doc every two weeks. It has been that way since 3/10 when I started. I have my chemo when the bloodwork results come in which are usually 20 minutes--they have a lab right there and don't have to send it to the hospital.

    Margo
  • lynn1950
    lynn1950 Member Posts: 2,570
    #12
    Where I'm from
    Where I'm from, I went in and had my bloodwork done. Then I saw my doc. It wasn't he gave the go ahead that I could even have my chemo! It's really logical to see your doc before they put all that poison in you. Tell the office manager that! I feel riled up just reading your post. You go! It is a shame that we have to fight so hard. Lynn
  • CR1954
    CR1954 Member Posts: 1,390 Member
    #13
    I always......
    I always saw my onc before each chemo infusion. he would go over my bloodwork with me and ask about symptoms or any side effects that I was having.

    What is great is that he is just two doors down from the "chemo" rooms. So if there is any question regarding what he has ordered, the nurse is able to just go & verify with him.

    BTW, have I mentioned that I love my onc? He has the biggest laugh!
    I also adore my rad onc. He is the sweetest and kindest man!
    I have no idea what my feelings about my oncs have to do with anything in this thread, but there you have them! LOL!

    CR

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