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Tomo RadiationHow to convince the insurance company to approve treatment they have refused?

I am looking for help from anyone who has had to fight insurance companies to get the treatment they DESERVE.My Father (56) was diagnosed with prostate cancer that has metastasized to his hipbone. His original PSA was 184. He began hormone therapy in February and hormone therapy dropped to 60 and 26.6, and hopefully low, but did not get the latest results yet. His Gleason score was 9 (5 +4). His biopsy showed that the prostate had undifferentiated carcinoma (which means that the cancer has been solid throughout). He began to see the doctor at City of Hope and has signed a clinical trial on hormone therapy and helical Tomo. The spiral Tomo Therapy is looking it will be his best chance to fight against this cancer. This type of radiation spirals around the tumor and all hits it from hundreds of different angles that moves around. Blue Cross Blue Shield has refused treatment, how can we struggle against it???

My son has a very rare sarcoma abdmoninal who do not follow a known protocol. For this reason it is often denied benefits, including treatment we believe may have saved his life. What we have done, and what you should do is file an appeal. Continue.

Even if my son was a stage IV, without knowing the "cure" available, the insurance company would deny the benefit of being based on "medically necessary". At first we were just too scared not to react emotionally, but we quickly learned that if we spoke calmly enough people that eventually they approve the benefit based on "need compassion. We need to go through two calls for a refusal. One thing you must do is to ask specifically for an expert in your type of cancer fathers to review the treatment plan. We have asked our insurance company give us the names and titles as reviewers. Once we had a case review to someone who understood what we were against its benefits have been paid.

Another option is to contact your insurance office to register a complaint states. And, you should also put a call into your local and state officials (the latest thing they want is bad publicity).

Turn a lawyer than as a last resort. It is best to simply try to reason with the insurance people first. You can also check to see if your father may be cases where a worker "to help you manage your insurance (the company provides a social worker who can guide you through some of the process - although they can not determine benefits).

Do not give up. Keep after the insurance company, especially if you think they should cover this expense. Get your fathers medical team get back to you on this subject, ask them to write or speak to your insurance provider dads.

It's hard work sometimes and we are always at work. It helps to keep a notebook and write everything also, any correspondence which you speak, and dates. I have an enormous backlog and keep all insurance and billing in plastic sleeves are sorted by date. Works really well.

Good luck. I know what it's like, just stay cool and go after what you deserve.

Why should they refuse treatment when your father was a volunteer on a new drug = If anything they should be offset your father to be called a pig for them = GUINEA sometimes I think the government sucks

It's terrible. I thought that when hospitals were testing a drug that they gave free. I think you can challenge the decision of insurance co. but I doubt that if you want to win.

If it is to have an experimental treatment no insurance will cover the same disease Go to your doctor and see if there are grants covering costs case of a clinical trial, it should be free of any way.

It may be difficult to find insurance companies keep cancer patients and Hel.

Posted on March 19, 2010.
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