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Insurance Denial

Teckguy
Posts: 1
Joined: Feb 2018

I was diagnosed with Stage 4 prostate cancer that metatisized to the bones. After 18 treatments of chemo my Doctor wanted a petscsn done but because he just put prostate cancer the insurance company refused to approve it. When we called health-first they stated that if the doctor would have put that it metastisized to the bone instaed of just prostate cancer it would have been approved. I told this to my doctor and he said it wouldn't make a difference. That I was in partial remission and he probably would put me on pills to help fight the cancer in the bones but no signs of the cancer being active shows. Meanwhile I had to see another doctor for something else and he took x-rays of my body and they showed up black. He looked at me and said, after telling him what I was told by the oncologist, that if it were him I'd go get a second opinion because from what I see your full of cancer. So what do I do now, call my doctor a liar regarding the petscan. However, I was told from someone in the health field that chemo makes the x-rays show up black. Anyway, I am seeing another oncologist in March. I have no faith in the doctors in florida or the ones that belong to health-first.

hopeful and opt...
Posts: 2226
Joined: Apr 2009

You are the CEO of your Medical team. These doctors are hired hands that work for you. You need to do what is best for you.

Here is information about the new FDA approved PET scan. 

http://paact.help/new-pet-scan-approved-for-prostate-cancer-for-psa-recurrence-after-treatment/

As far as PET Scans; there are varous ones; some better than others. There are PET scans that are investigational that you must pay for that provide better information. Additionally there are studies that you can enroll in. 

Here is a good one that will cost approximately 2500 to 3000, if you so wish.

http://paact.help/update-c11-acetate-petct-in-prostate-cancer-fabio-almeida-md-2015/

 

Old Salt
Posts: 720
Joined: Aug 2014

You can appeal decisions made by the insurance company. Just keep on fighting.

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