All is Not Lost

I called the finance people over at Ironwood Cancer and Research Center this morning, and after doing some research on their end, they told me that it isn't the Chemo that my insurance company is denying coverage upon, it's the Aranesp shot that helps me keep my white cells where they need to be.  And wow, I had no idea each shot was $4040!

There was nothing on the insurance paperwork that specified what they were denying, and I was so freaked out yesterday.  Sally at Ironwood told me NOT to worry; they had faxed over the required information at least three times, and by gods they'd do it three more times, if they had to.

So, I'm in a much better place today and hopefully I can get some sleep tonight.  I did manage an hour and a half this morning, and it's amazing what that little bit of sleep can do for your spirit.

The nausea was pretty bad today, though.  I'm thinking the stress of the insurance company fiasco (and note, I never say which insurance company I have, as I don't want them suing me for telling the truth about them.)  So I did take a compazine and I think it's about time for another.  But the pain in my thigh is totally gone now, and I can walk pretty well again.  Still, I'm taking the scooter to my lab tests tomorrow, just because I'm feeling so puny from the chemo.

Thank heavens for all the folks at Ironwood.  They are such professionals and always have great attitudes.  You can't help but be impressed.  There's nothing worse than a good doctor with crappy staff, but at Ironwood, you have the best of BOTH worlds. :)

Peace out. :D

Never SAY You are Lucky

I got home from my chemo today to find NUMEROUS letters from my insurance company telling me in several pages of gibberish that they have denied my claims on my chemo treatments.  They are telling me I now owe my oncologist just over $28,000.  Um, yeah.

So, I called them and they said the data my oncologist had provided was not enough.  They needed more justification.  They decided this back on my first treatment in August, but just now decided to let ME know.    Well, if they needed more information, why didn't they contact my doctor?  Oh, not their job!  How odd, I could have SWORN it WAS their job.  But, hey, they don't want to pay that $28,000 either, nor $4040 for any additional chemos.

And I ask myself.  WHY do I have medical insurance if they don't cover crap I need to stay alive.  Or get some sleep.  But note the lack of question marks there... it's all rhetorical.  They don't give a flying rat's ass.

Well, I'll be sure to call my oncologist's office tomorrow, because if my insurance is not covering it, we're going to have to stop the one treatment regimen that was actually saving my life.  I will not put my family in jeopardy and debt.  Granted, I'm sure this will all be resolved once I talk to the Oncologist.  HIM I have faith in.

I'm sure it would all look less dire in the morning, after a good night's sleep, but WAIT!  It's the Dreaded Decadron Insomnia night, for which they denied me a good night's sleep.  Alas.

Instead, I'm sure I'll be even more of a sarcastic bitch in the morning.  Pray for whomever answers the phone at my oncologist's office.

Hell's Bells!

Ok, I had turned off the Air Conditioner last week, when we were experiencing high 70's through high 80's weather and it was great, but this week, we're back to high 90's again.  This is actually normal for us here in the Phoenix metropolitan (dang, that word is a pain to type!) area for this time of year. 

If you notice on my Weather Channel widget, our lows are great; tonight we'll hit 64... blanket weather! ;)  So, now that the sun is long past being down, all my windows and doors are open and the fans and cross currents are bringing that cooler air into the house.  And it's LOVELY!

Jane says she heard our Great Horned Owls last night, so I hope I get a chance to hear them soon.  Our bats were back again this evening as we were all out enjoying the sunset and the cooler temperatures.

Went and had my PT/INR today, since Dr. R has changed my schedule from Monday and Friday to Monday and Thursday.  Had a chat with my case worker from my insurance company, wondering WHY this time, they wouldn't cover the Coumadin Clinic.  She's going to find out.  Seems my insurance isn't covering quite a few things these days, not the least of which is the only sleep aid that I, as a person with advanced lung disease, can actually use.

Yes, I broke down and asked Dr. R for a sleeping pill to use on my Dreaded Decadron Insomnia nights.  He prescribed Rozerem, which doesn't have a sedative effect, which would be a bad thing for a person with lung disease and sleep apnea.  But my insurance company said "prescribe Ambien" to which my doc said... diplomatically... "NO!"

Oh sure, I could spring for it myself, but for two nights in a month, they can bite me... I'll just stay up all night.  It's not cheap, by the way.  And frankly, I have other, much more important, priorities on my finances right now.  But, you know, I'm freaking sick of non-medically trained bureaucrats (dang, that's even harder to type!) telling MY DOCTOR how to prescribe medicine, when they don't know crap about me as a patient.  Yeah, I'm perturbed... which is nicer than saying this pisses me off royally.  Probably because I'm sleep-deprived.  Alas.

Still, all in all, life as I know it is fantastic, beaurocracy-ridden insurance companies notwithstanding, and so, I have a smile on my face, a song in my heart and a glass of red wine at my side.  I have a huge family that loves me to bits, friends that give me shoulders galore, and chihuahuas that provide unquestioning adoration.  For what more could one wish?  A freaking good night's sleep on Dreaded Decadron Insomnia nights!!!!!

And could I also ask to be rid of this silly twitch in my left eye?

Love to all. :)

Medical Leave Denied...

So, don't you just love it when you're sitting all happily contemplating the relaxation of your impending weekend and then.... you say to yourself, "I should go get the mail."  And there they are, the harbingers of doom; two letters from Aetna. 

"Ahh, this must be my actual leave confirmation," I say to myself.

Then I open the first one.  "As of 11/5/2010, we have not received the necessary information to make a determination of your claim.  Therefore, your claim has been denied."

Ugh.  So, I call them, and reached Laurie. If everyone at Aetna is as wonderful and kind and helpful as Laurie, this will all be straightened out in no time. She's faxing the forms back to Ironwood, who I know for a fact faxed the original forms to Aetna on the 4th of November. 

So, it's just a bump in the road, but it did get  me a bit stressed out.  But really, I was very impressed with Aetna's Laurie and salute her willingness to take some time to go through all the records and do what she could.  Blessings to you, lady.

Trouble on the Insurance Front...

Dr. F contacted my insurance company today regarding treatment with Herceptin, and they disapproved it.  This is odd, since it was approved by the FDA for HER2 positive Gastro-esophageal cancers just a few weeks ago. 

Dr. F was very upbeat about my chances with the addition of Herceptin; he's the doctor!  Some insurance administrator, who looks at a list should NOT have the authority to keep me from a treatment that COULD SAVE MY LIFE!

Dr. F has vowed to fight for this, and he will, but gosh, ... how demoralizing.  Am I *that* naive that I just assumed it would be fine because my oncologist says it's what I need?  He doesn't go around trying to find ways of screwing people's insurance companies... HE'S TRYING TO SAVE OUR LIVES!

So, can you tell I am both angry and practically in tears, which I get when I am angry, and if you know me, and my whole asthma problem, you know that crying makes me sick... really, really sick.  So, I will not cry.

Anyway, if anyone can make my insurance company listen to reason, I think Dr. F has a good chance. 

Well, I feel the need to go pound bad-guys into the earth, so I think I'll go load up Fallout 3, and whack away my frustrations in good, wholesome, virtual violence. :)

Hugs and kisses!