Insurance Denied IMRT

howdybooth
howdybooth Member Posts: 42
edited March 2014 in Uterine Cancer #1
My sister's insurance - Aetna - denied her rad/onc prescription for IMRT since her cancer is listed as Stage 1B Grade 2. Nice! The radiologist doesn't feel that her cancer is acting like a stage 1B and has sent slide to MD Anderson Cancer Center in Houston to review her path. Has anyone else had to fight the insurance company on this and won? Also, what do they (the ins. company) have in place that allows them to over rule a doctor's orders? Are they practicing medicine without a license in the state of Texas? Don't get it at all! She can't have more surgery or very strong Chemo because of her heart and radiation is basically her only choice! Frustrating that you have to fight the cancer and the insurance!

Comments

  • Songflower
    Songflower Member Posts: 608
    Insurance
    Get a lawyer and fight them. Write a letter about what you just wrote. Fight now.
  • nursey420
    nursey420 Member Posts: 52
    talk to the doctor
    Have your doctor write a letter to the insurance company and enclose your medical records. Make sure t states this is not optioinal and that it will defer further treatment hence less costly in the long run. Godd luck and don't stop fighting
    Lisa