Getting approval from Insurance Companies

Posted by davester @davester, Dec 20, 2022

Need any idea's, I am 63 so no Medicare.
I applied for 28 Proton Treatments thru Blue Cross of Il., if I cannot get that than going for SBRT 5 treatments.
Question is if anyone was turned down, what did you do to try to get approved.
Thanks Dave

Interested in more discussions like this? Go to the Proton Beam Therapy Support Group.

I have had a terrible battle with my insurance, (Prostate Cancer) From my Dr's office not sending in the approvals in a timely manner, to the insurance dragging their feet. All I can say, is that you have to be your own advocate. You need to call the Insurance and ask questions and push the approvals. You need to call the Dr. and make sure they are sending them in. It sucks. All of this is just undue stress in a time where you do not need anymore stress. Keep pushing. That' s all I can say. I had to push very hard. From getting appointments in a timely manner to getting insurance approvals. And watch your insurance statements. I found one thing they billed me for that they said wasn't approved, AN MRI, and it actually was. Yet another phone call to fight for myself.
Good Luck!!!

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CORRECTION: Some weeks ago, I stated Mayo in Jacksonville does not take Medicare and/or TriCare for Life.
This statement was incorrect. When I called Mayo initially, I was forwarded to the office in St Augustine which manages primary care only. That office and medical support does not take Medicare.

But, specific issues (cardiology, cancer, etc), the main facility in Jacksonville accept Medicare and Tri Care for Life (those of retired military).

I scheduled a call a couple of days ago. The Mayo rep corrected my original statement (based in part of the call to the St Augustine office). They gave me a Mayo Clinic patient number. Therefore, any doctor who wishes to refer you to Mayo Clinic in Jacksonville should use that referral number for immediate identification.

I came onto the postings reference proton radiation treatment done in 2010 at Loma Linda Hospital in Loma Linda, California. All is well!

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@tom86

Mayo in AZ accepted my husband's Medicare....no problem. We had a supplement to Part B, however. If AZ accepts it, can't imagine why any Mayo would not. Perhaps they do not accept it if VA is involved.

Jump to this post

I posted a retraction of the statement made about Mayo not accepting M-Care and or Tri Care.

The St Augustine office of May said..in part.."we don't accept M-Care for primary care.."\

MAYO ACCEPTS M-CARE FOR SPECIFIC ISSUES TO WHICH MOST ARE INTERESTED IN THESE POSTINGS. PRIMARY CARE WOULD BE YOU LOCAL DOCTOR. FOR REFERRAL TO MAYO, YOU WILL NEED A MAYO PATIENT NUMBER AND BACKGROUND INFO. I DID THIS VIA THEIR "APPOINTMENT" REQUEST. THE MAYO PERSON WAS VERY PROFESSIONAL AND CLARIFIED COMMENTS ABOVE. GET INTO THE SYSTEM AS MENTIONED.

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