Rectal Cancer Survivor

I am so glad that everyone ignores me, even when I try to be compassionate. I certainly deserve such treatment. I wish I would have died of the cancer, my life is shit and no one cares.

I’m so sorry that you have gotten to this point. Having cancer is bad enough, but having to fight your insurance company too definitely stinks. I don’t know your story so it’s difficult for me to help. I care.

I’m really sorry to hear that you feel ignored and (it sounds) hopeless. I’ve had to remember that these online support groups aren’t like instant messaging friends, the response (which feels like forever when you are feeling desperate), can take far too long. As far as your insurance company goes, I don’t know what you are dealing with, but can tell you that I’ve had to contest declined coverage 5 times, before it was finally turned over to mediation, & immediately covered. Don’t give up, or pay them. Which I understand is too much to ask of us, in the weakened state from this disease. Tell your doctor (or nurse) you are feeling this way. Maybe they can help, or find a local advocate for you. ❤️

@hopenjoy2024
I am so glad you had successful treatment. We are all here to help you. Let us know what the insurance company is doing and which stakeholders are involved. We may have some suggestions that may help you deal with your current situation.

I know what it feels to be struggling/suffering and not having anyone (friends family) who are close and offering to help us so I can really empathize with you. I used to work for a healthcare insurance company and know some of the ways to work with them. I am currently fighting along with the provider for an appeal with my insurance company (former employer) to get my surgery covered next week. They are trying to delay/deny to not pay for a necessary spine surgery.

Thank you all for tolerating my tantrum. To explain my situation: I had to switch to an ACA HMO at the start of the year. I found a wonderful GP who was a great addition to my care team, as she was familiar with most of my oncology team. However, the rectal surgeon (who is in network), used the referral from last year so Aetna denied claim because there was no pre-authorization. Then they said I had needed to request continuity care for ALL medical care associated with the cancer so they denied all oncology follow-ups. Now they said they will not cover my colonoscopy because I had one last year (when the cancer was diagnosed) so I am not eligible for another for five years. @dlydailyhope

Which insurance company? Please provide details.

@hopenjoy2024
Did your surgeon’s office not get preauthorization for your surgery and post surgery care? That is what they should do. Members/patients should not have to push this process when the provider needs to provide clinical information to Aetna for preauthorization approval. They should not have done the surgery until everything was buttoned up. I would ask that practice manager for help getting post surgery appeal approval of all medical claims for surgery and post surgery oncology. You may need an attorney to help you and you can check your state for help with your insurance claims. You should not be penalized during a scary time when you were relying on your providers for care.

I am fighting the same problem where Aetna is denying coverage of surgery and needs the surgeon to do a provider appeal. I met with him 6 weeks ago and my surgery is Monday. Why the surgeon’s preauthorization team dropped the ball, I don’t know. Very frustrating.

@dlydailyhope
Just cannot understand how you can get this sorted before Monday and if not, they will likely charge you fora no-show if you cancel now- not to mention a re-schedule wait.
And I am now stuck in process of waiting patiently for the appeal process to play out.

Yes, it was an anoscopy in office, 6 month check up. The surgeon’s office pre-auth-ed with the new insurance but submitted the claim using a referral from the oncologist, not the GP which is not allowed. When the claim was denied, they sent me a bill, which I paid on the assumption it was copays and coinsurance since it was a new year and out of pocket maximums did not apply. If I would have contacted the doctor’s office when I received the bill, they would have been able to appeal and resubmit.

@hopenjoy2024
Since the office made the error, they should definitely correct it and resubmit the claim, complete the appeal, and reimburse you what you overpaid.