Pinky Pie

Radiation therapy, insurance & Me

Posted on: January 5, 2010

The radiation oncologist wanted me to tell him about my perspective on my cancer diagnosis and treatment. He didn’t want me to tell the story technically but from my own perspective.

“Tell me it as a story,” Dr. Kirnan Minehan said.

“No problem,” I told him, “I’m a personal historian. This is what I do.”

So I began slowly: “I was born in the house …”

“Maybe we don’t have time to go back that far,” he said.

We both laughed.

I like this guy, Dr. Minehan, and physician assistant, Dale Groshek. They are the first “boys” that I’ve had on my treatment medical team except for a nurse in chemotherapy. They are kind, caring, thorough and empathetic. And they laugh at my jokes.

As it turns out, the radiation oncology department also is determined to secure the insurance approvals for radiation therapy from our new insurance company, which is notorious for saving money for employers by not providing needed services to patients. Or, it makes squirm and jump through hoops to get life saving treatments.

Lucky me. The radiation oncology department down the hall is out of network.  The new insurance company has generously approved seven office visits for me, but that is separate from the simulation (development of the treatment plan) or the actual treatments themselves.

I actually need high dose radiation and probably 33 to 35 treatments instead of 30 it wanted to go forth and multiply. My cancer as far as can be seen on scans and biopsies stopped at the lymph nodes. The cell type of the cancer is promising for being treatable, a reason Dr. Minehan said we are going for cure.

“You need radiation,” Dr. Minehan said, making sure I understood that. I do.

Our new insurance company may not have that understanding or give a rat’s ass even if it does. I’ve learned the company is notorious in the medical world.

How many times have you said something like, “My teacher is the worst,” or “My dog is the worst, etc.? You might even say, “My insurance company is the worst.”

But you don’t really know that for sure. I can truthfully say that our new insurance company as of January 1 is the worst and it is only January 5.

I will call our company It That Shall Not be Named Healthcare because at this point my life is literally in the company’s hands and I don’t want it to decide to get even with me because of anything I write.

It That Shall Not be Named Healthcare received the worst ranking in the third annual National Payor Survey of hospital executives. Eighty-two percent of respondents to the survey had an unfavorable opinion of It That Shall Not be Named Healthcare. Wow.

You think it couldn’t be any worse that that. As it turns out that 82 percent disapproval in 2009 was actually an 8 percent improvement for It That Shall Not be Named Healthcare over the previous year.

(http://www.daviespublicaffairs.com/downloads/2009DaviesNationalPayorSurveyRelease.pdf)

Everyone is frustrated these days with their insurance company so you might think it can’t be so different than yours. The survey found the average unfavorable rating for all other insurance companies is 34 percent.

A news release by DAVIES, a public affairs agency that conducted the survey, said  ofIt That Shall Not be Named Healthcare, “They have a reasonably good reimbursement rates for hospitals and physicians, but the survey reveals that hospitals simply don’t trust (It That Shall Not be Named Healthcare) to follow-through on its promises.”

The dissatisfaction is driven by “distrust, dishonesty, flawed business process, inadequate claims processing, claims denials and other business process problems.”

I know that calling the company It That Shall Not be Named Healthcare is a Harry Potter rip-off, but I didn’t know anything to rip off from the Twilight books and movies.

Once again I’d like to say, I’m sure glad the government is not between me and my doctor because there’s simply no room with the insurance company smack in the middle.

Have guts public officials. We need a public option for everyone. Insurance companys don’t care about patients. They care about profits.

I’m not against profits except when they become more important than human beings.

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1 Response to "Radiation therapy, insurance & Me"

I say again, “bastards”.

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