How do we convince insurance company to approve treatment they denied?
I am looking for help from anyone that has have to battle the insurance companies in decree to get the treatment they DESERVE.My Father (56) has be diagnosed with prostate cancer that has metastasized to his hip bones. His resourceful PSA was 184. He started hormone therapy within February and with hormone therapy it have dropped to 60 and then 26.6, and hopefully lower; but haven't gotten the latest results even so. His Gleason score is 9 (5+4). His biopsies showed that the prostate had undifferentiated carcinoma (meaning that the cancer be solid all the way through).He have started seeing Dr's at City of Hope and has signed up for a clinical trial using hormone therapy and Helical Tomo Therapy. The Helical Tomo Therapy is looking similar to it is going to be his best opportunity to fight this cancer. This type of radiation spirals around the entire tumor and "hits" it from hundreds of different angles as it travels around. Blue Cross Blue Shield has denied the treatment, how do we row this?
Answers:
It can be hard to find insurance companies that will keep cancer patients and assist them. I'm not trying to scare you. I would call a advocate referral service in your area ( the intial consultation is usally free) and "discern them out" regarding the best approach. FYI: Although your father is just 56, you may want to investigate, at some point, getting him on Medicare Medical Disability. One of the lawyer who advertises frequently in my nouns of Texas is Ronald D. Honig. He handles Social Security & SSI Disability cases. Per the ad on pg. 190 0f the January 2007 AT&T Yellow Pages: "Over 30 years experience. 12 years as a Social Security Staff attorney. Free Intial Consultation. Retirement, Widows, and Childrens claims. 1.800.359.0019 or 214.368.0777. 9400 N. Central Expressway # 905 Dallas, Texas 75231. Not certified by the Texas Board of Legal Specialization."
If he is have experimental treatment No Insurance will cover it even Medicare Go to his Doctor & see if there are grants covering expenses If it is a clinical trial It should be free anyway.
why should they deny treatment when your Dad is being a volunteer on a new drug=If anything they should be compensating your Dad for one a so called quinea pig for them=sometimes I think the organization sucks
Agree with everything above, but I suggest you also bring the problem back to City of Hope and your doctors. It's contained by the hospital's interest to help you through the appeal process, and most have administrative specialists that can abet you.
try a hompathic doctor, some one that know how to cure cancer by raise body ph level and killing the cancer next to out killing the patient, caner cannot live contained by a high oxygen, high hydrogen attmostphere, so simple and on the other hand doctors are killing people next to chemo
that is to say terrible. i thought when hospitals were conducting tests a drug that they gave it for free. i think you can contest the insurance co decree. but i doubt if you would win.
My son has a very in danger of extinction abdmoninal sarcoma that does not follow any known protocol. Because of this he is frequently denied benefits including a treatment we feel may own saved his life. What we did, and what you entail to do is file for an appeal. Continuously.
Even though my son was a stage IV next to no known 'cure' available, the insurance company would deny the benefit based on anyone 'medically unnecessary'. At first we were just too horrified not to take action emotionally, but we soon learned that if we talked steadily to enough people that eventually they would approve the benefit base on 'compassionate need'. We did need to go through two appeals for one denial. One point you need to do is ask specifically for an expert in your father type of cancer to review the treatment plan. We asked that our insurance company provide us with the reviewers name and credentials too. Once we have someone review the case who understood what we be up against his benefits were paid.
Another chance is to contact your states insurance bureau to register a complaint. And, you should also put a call into your local and state representatives (the last article they want is bad publicity).
Turn to a lawyer singular as a last resort. It is best to just try and use with the insurance people first. You might also check to see if your father can hold a 'case worker' help you manage his insurance (the company provides a valise worker who can help guide you through some of the process - although they can't determine benefits).
Don't give up. Keep after the insurance company, especially if you grain they should cover this expense. Get your fathers medical team to subsidise you on this, have them write or talk to your Dads insurance provider.
It's profoundly of work sometimes and we're still at it. It helps to keep a notebook and write everything down too, any correspondence, who you converse to, and the dates. I keep a huge notebook and preserve all insurance and billings in plastic sleeves arranged by date. Works really capably.
Good luck. I know what its like, just hang on to cool and go after what you deserve. Source(s): Experience. Teen son diagnosed with stage IV abdominal sarcoma.
I went through this myself for different medical treatment and it was Blue Shield. They ALWAYS deny everything hoping you will not box it. Put together an appeal letter stating the reasons why it is so essential and give a good argument against their reason for denying. Get Drs to write letters to attach to appeal. Also attach any studies that have be done to prove that the therapy works. I did this and it was approved really quickly after they got my appeal. This is on a med that costs $1200 a month for duration.
Related Questions:
Answers:
It can be hard to find insurance companies that will keep cancer patients and assist them. I'm not trying to scare you. I would call a advocate referral service in your area ( the intial consultation is usally free) and "discern them out" regarding the best approach. FYI: Although your father is just 56, you may want to investigate, at some point, getting him on Medicare Medical Disability. One of the lawyer who advertises frequently in my nouns of Texas is Ronald D. Honig. He handles Social Security & SSI Disability cases. Per the ad on pg. 190 0f the January 2007 AT&T Yellow Pages: "Over 30 years experience. 12 years as a Social Security Staff attorney. Free Intial Consultation. Retirement, Widows, and Childrens claims. 1.800.359.0019 or 214.368.0777. 9400 N. Central Expressway # 905 Dallas, Texas 75231. Not certified by the Texas Board of Legal Specialization."
If he is have experimental treatment No Insurance will cover it even Medicare Go to his Doctor & see if there are grants covering expenses If it is a clinical trial It should be free anyway.
why should they deny treatment when your Dad is being a volunteer on a new drug=If anything they should be compensating your Dad for one a so called quinea pig for them=sometimes I think the organization sucks
Agree with everything above, but I suggest you also bring the problem back to City of Hope and your doctors. It's contained by the hospital's interest to help you through the appeal process, and most have administrative specialists that can abet you.
try a hompathic doctor, some one that know how to cure cancer by raise body ph level and killing the cancer next to out killing the patient, caner cannot live contained by a high oxygen, high hydrogen attmostphere, so simple and on the other hand doctors are killing people next to chemo
that is to say terrible. i thought when hospitals were conducting tests a drug that they gave it for free. i think you can contest the insurance co decree. but i doubt if you would win.
My son has a very in danger of extinction abdmoninal sarcoma that does not follow any known protocol. Because of this he is frequently denied benefits including a treatment we feel may own saved his life. What we did, and what you entail to do is file for an appeal. Continuously.
Even though my son was a stage IV next to no known 'cure' available, the insurance company would deny the benefit based on anyone 'medically unnecessary'. At first we were just too horrified not to take action emotionally, but we soon learned that if we talked steadily to enough people that eventually they would approve the benefit base on 'compassionate need'. We did need to go through two appeals for one denial. One point you need to do is ask specifically for an expert in your father type of cancer to review the treatment plan. We asked that our insurance company provide us with the reviewers name and credentials too. Once we have someone review the case who understood what we be up against his benefits were paid.
Another chance is to contact your states insurance bureau to register a complaint. And, you should also put a call into your local and state representatives (the last article they want is bad publicity).
Turn to a lawyer singular as a last resort. It is best to just try and use with the insurance people first. You might also check to see if your father can hold a 'case worker' help you manage his insurance (the company provides a valise worker who can help guide you through some of the process - although they can't determine benefits).
Don't give up. Keep after the insurance company, especially if you grain they should cover this expense. Get your fathers medical team to subsidise you on this, have them write or talk to your Dads insurance provider.
It's profoundly of work sometimes and we're still at it. It helps to keep a notebook and write everything down too, any correspondence, who you converse to, and the dates. I keep a huge notebook and preserve all insurance and billings in plastic sleeves arranged by date. Works really capably.
Good luck. I know what its like, just hang on to cool and go after what you deserve. Source(s): Experience. Teen son diagnosed with stage IV abdominal sarcoma.
I went through this myself for different medical treatment and it was Blue Shield. They ALWAYS deny everything hoping you will not box it. Put together an appeal letter stating the reasons why it is so essential and give a good argument against their reason for denying. Get Drs to write letters to attach to appeal. Also attach any studies that have be done to prove that the therapy works. I did this and it was approved really quickly after they got my appeal. This is on a med that costs $1200 a month for duration.
Related Questions:
- Do insurance Company want to rate for motor form after accident?
- Do you know any Insurance Company help race who have Hep C virus?
- Any insurance company cheaper than Progressive?
- Is Direct Travel insurance a O.K company to insure holiday near?
- Has anyone get name & numbers for an insurance company who'll insure a double decker bus?