Ft scan denied

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Soup52
Soup52 Member Posts: 908 Member
in Uterine/Endometrial Cancer #1

Well after astressful week involving my mother-in law, I received a call from the oncologist office that my HMO insurance has denied me having a scan. I'm very upset about this since my original diagnosis was 3C with clear cell. Yes, I have been clear for a year but wanted some assurance that I was still. Ok they said I wasn't having any symptoms. Hm, I'm still bothered by intestinal problems that I'm seeing a gastroendenologist for. I know this can be related to radiation I have had but still....Just because I'm not bleeding. Fact is I wasn't bleeding heavily when cancer was found and still high grade. Am I over reacting or paranoid or what?

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  • TeddyandBears_Mom
    TeddyandBears_Mom Member Posts: 1,811 Member
    #2
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    Hey Soup,

    Hey Soup,

    I don't think you are over reacting. I'm torn about getting scans. My previous local oncologist wanted me to have them every 3 months and my surgeon oncologist didn't want me to have any without symptoms. I had agreed on evey 6 months with my local and my insurance denied it as well. And, I have insurance that is normally open to things. It has been a year and 3 months since my last scan and I still get that feeling of wanting to know nothing is lurking in there!

    And, just what are the symptoms that warrant a scan? Bleeding can't be the only one, right? If someone ends up with mets someplace outside of the vaginal cuff, what does a person look for?

    Anyway, for me... I'm going with the surgeon's advice to not get them and trust that the poking, peeking and prodding they do at the 3 month exams is enough to ensure that I'm still NED.  CA125 staying within the normal range is also helpful. Although, mine is higher now (still normal) than it was when I had cancer. Doesn't exactly make for a warm fuzzy. ugh

    I hope you find a way to find peace without the scan. If not, ask them to push the insurance company.

    Love and Hugs,

    Cindi

     

  • Nellasing
    Nellasing Member Posts: 528 Member
    #3
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    Sorry Soup!

    Boy do I identify with wanting to know!!!  My gyn/onc is also one who doesn't believe in scans unless symptoms warrant one.  I was having some pain so did go and pay out of pocket for an ultrasound- I have a friend who is an ER Dr. and he said they rely on those heavily and thought it would be worth it to have a non invasive look inside- it was all clear.  Perhaps your ins. would pay for one of those with your other intestinal problems?  FYI My gyn/onc didn't like the idea of those either- she said it could pick up fluid and scar tissue and they get false positives.... I thought it was worth it for a bit of peace of mind.  (((HUGS)))

  • Kvdyson
    Kvdyson Member Posts: 789
    #4
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    Appeal

    I don't think that you are overreacting. I believe the insurance company is required to provide you with an appeal process if they deny a procedure. Have you (or your onc) contacted about that process? You know what they say about the squeaky wheel getting the grease. Maybe it's time to start squeaking!

  • survivingsu
    survivingsu Member Posts: 134 Member
    #5
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    Argh!

    I really hate it that insurance companies (businesses) have the power to make medical decisions re allowance of certain tests, etc.  I think the need for scans and tests should be based on what the doctors recommend and not what businesses would like to do to cut corners.  If the doctors think a scan is merited and important, it is my understanding that they have work arounds to make sure the scan is not denied by insurance.  In some cases it is a matter of entering the correct code.  I recommend working with your doctors, sharing your symptoms with them, and finding out what they recommend.  There are lots of options out there, different kinds of scans, referrals, lab tests, etc.

    Wishing you the very best!

  • christines2060
    christines2060 Member Posts: 6
    #6
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    It's never easy

    Hi,

    I hope you find a way to get your scan done, I go for mine tomorrow and had to be a little forceful to get it done- goodluck!

    Chris

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