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Frustration with biopsy scheduling due oi MRI issues
I have to vent. I was scheduled to have my fusion biopsy today and yesterday they cancelled on me and told me that the next available is August. I had my MRI 3/12 due to rising PSA over a 3 month period. It came back with a Pi-Rads 4 due to an ill defined lesion in the peripheral zone and positive DCE (meaning angio genesis is already underway. Every other parameter also point to aggressive disease.
As requested I took my MRI disc to my urologist appointment on 4/16 and scheduled me for a fusion biopsy for today (6/2) and was going to get me in earlier if possible due to the alarming MRI report.
Now for the problem. My MRI was performed in South Carolina (where I have a second home). I received a call one week before my biopsy from my urologist in Delaware telling me that the hospital was unable to read my MRI disc required for the fusion biopsy. Fortunately I was in SC and was able to have them burn a second one and drove 11 hours the next day to get it to them. The hospital radiology dept. could not read the second disc either. They then had the SC hospital upload the MRI file directly to them. Again they could not read it. They said that they would work on it, and I received an email confirming my procedure today so I thought all was good. Yesterday the doctor's office called and cancelled and had me bring the disc back to them so that they could send it to MSU in Mass. where they thought they could read it.
Now I am at their mercy trying to schedule my biopsy with them telling me the next available slot isn't until some time in August! I asked if I couldn't just get another MRI in DE but they said that insurance wouldn't cover the second MRI. I am so frustrated knowing that I have an aggressive cancer that could metastasize and that time is of the essence.
I have reached out to Johns Hopkins for a second opinion since they are a center of excellence but they want the MRI and biopsy info before they schedule it.
It is so discouraging. I don't know what to do. I can't sleep and this is so stressful.
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@keithl56
Ask your urologist/radiologist/ordering provider to place a new request with wording such as “urgent,” “stat,” or “expedited” and to include the clinical reason (e.g., concern for clinically significant prostate cancer, staging, treatment planning, worsening symptoms, rising PSA pattern, etc.).
Many hospitals and Imaging centers will change a schedule because of the wording from that doctor. It’s worth a shot.
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2 Reactions@thmssllvn
I'm waiting to see if MSU in MA is able to read my disc, if so, I will be OK to get the biopsy rescheduled. If I have to repeat the mpMRI I think that my doctors off ice will be an advocate with insurance. My original MRI was $7000 but I paid zero. If I have to pay out of pocket I can and will to get things moving again. I just hate that all of this delay could have serious ramifications regarding treatment options and quality of life issues.
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2 Reactions@bens1
Thanks. I agree and it seems that the urology practice is on top of it. Somebody dropped the ball on this and I'm subtly letting them know that any undue delay will not be accepatable.
I was making slow but steady progress at Mayo Jax, but then hit my first roadblock of getting MRI done, had to return weeks later to get MRI. Then again, more progress but hit my second roadblock, they had zero biopsy appointments available, not that I was unhappy with the timing, but they said no appointments were available for a prostate biopsy in Mayo Jax. I then pivoted to Mayo Rochester to get biopsy, it was a boatload of work to get this appointment, but eventually got it. Later thru process got RARP at Mayo Jax, very pleased with Mayo Jax and surgeon. Just saying even at this COE, it was frustratingly slow.
Best of luck, you are making progress, don't give up, keep on pushing.
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1 Reaction@keithl56 I can guarantee that the $7000 is the inflated "retail" price and is not what your insurance paid. Most discounts for radiology are in the 70%+ range. Part of the ripoff of the US medical establishment. When my insurance refuses to pay they say I should pay the full retail in their EOBs. I got a $664 radiology charge on my mpMRI insurance said was not medically necessary. I appealed it. Before the appeals were over the practice sent it to collections. Offered to pay at the same discount that insurance paid ($120) but this was not accepted. It was approved on external review and my insurance paid their contracted rate of $63 to the practice. The reviews probably cost them more than if they had just paid. I would have paid the $63 if that was offered to me vs. the appeals but was not going to be ripped off for $664.
Without mentioning the non CCOE hospital: I had a transperineally performed fusion biopsy. It was billed out at $35,000! of which $7,000 was considered and $5,000 was paid [80%/86% discount]. The biopsy physician component was $135.00! Being salaried there was an incentive to keep the down stream 3rd party menu of services in house.
Keith56: MSU in MA means ? BTW: The two capital letter postal code for mail to Massachusetts is MA; whereas, the abbreviation is Mass. (LOL) I knew that part unless you meant something else. Google did not help me.
mistyped! United Medical Systems in Mass. They provide MRI fusion equipment and apparently my urologist thinks that they can perform some magic on my disc.
@thmssllvn
I am extremely fortunate since Medicare combined with excellent employer coverage means that I never see a bill (not yet, I probably jinxed myself).
After being ghosted by my urologist since they cancelled my biopsy I reached out to Johns Hopkins last Friday and explained my situation. They actually gave me an appointment for yesterday! What a difference! They were able to read my MRI disc which my local hospital couldn't do and scheduled a trans perineal fusion for 7/6 (my local practice said the next available biopsy (trans rectal) would be some time in August.
What a difference using a quality center of excellence makes. I was also impressed when they said that they were not going to treat my cancer, they were going to CURE it.
Although I have a way to go, I would highly recommend using JH based on my experience thus far.
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