Friday, February 25, 2011
I asked her if that meant they wouldn't cover treatment from an Oncologist in another state if that coverage was available from an Oncologist in the "home" state and she said she "didn't know" that she was "assuming" that wasn't what it meant... I don't know why she couldn't clarify what it meant???
Today, when I got home from work there was a letter from Medicaid saying that they have denied coverage because of several reasons, foremost being "The clinical information submitted does not describe a patient with Stage I "smoldering myeloma (cancer of plasma cells), solitary plasmacytema (tumor made up of plasma cells), or signs/symptoms suggesting progression of disease."
Another reason, "The clinical information submitted does not describe new or worsening signs/symptoms, or failure of laboratory tests to return to normal in this patient with history of myeloma (cancer of plasma cells). We are unable to authorize the above procedure based on nationally accepted imaging guidelines".
Never once when Tanner was first diagnosed did his "laboratory" work indicate cancer. The first Oncologist we saw in Fort Worth told me that if they were basing his diagnosis on his lab work, they would think he was completely healthy. Without the full body scan, they would have never found the over 100 cancerous lesions throughout the bones in Tanner's body.
Now, Medicaid wants to deny any further tests because Tanner's lab work doesn't indicate the disease is worsening or progressing.
I'm really without words at this time....
Wednesday, February 23, 2011
At this point, they are calling a Director at Texas Medicaid to see what can be worked out, in the meantime, Tanner's tests have, once again, been cancelled.
I told her we are going on three weeks now that Tanner has been without treatment. She copied me on her reply to the people in her insurance office stating that this needs to be taken care of quickly and Tanner be brought back to MIRT as soon as possible.
So, once again, we are on a holding pattern while they are sorting out insurance issues.
Tuesday, February 22, 2011
I'm closed up in the bedroom trying to make sure Tanner doesn't catch anything from me.
This really needs to pass so that I can get him to Little Rock for his tests Thursday and Friday. One of my friends told me stress is destroying my immune system. Maybe he's right. I wish I was like all of those people who can just take things as they come and not worry about what they can't control. Me, I worry all the time...
Anyway, here's hoping this passes without Tanner catching it and that we are okay to make it to Arkansas later this week!
Monday, February 21, 2011
The only thing that will work with Dr. Barlogie's schedule is for us to come for his tests on Thursday and Friday and then wait to see the doctor on Monday afternoon.
They emailed me a copy of the schedule they worked out and his tests start Thursday around 12:30 p.m. and ends with an MRI at 7:45 p.m. We'll be there all day until late at night, will have to go back on Friday to complete the rest of the MRI, and then wait all weekend to be able to see Dr. B on Monday...
I asked if this just applied to Dr. Barlogie and MIRT and if we would need to see a doctor here in Fort Worth about Tanner's leg since Dr. Nicholas doesn't take Texas Medicaid and Bonnie asked me to give her a few more days to "work on Dr. Nicholas". I haven't heard anything back yet, but I'm thinking any surgery that might have to be done on Tanner's leg, will most likely have to be done by someone here locally. When I talked to Dr. Nicholas' nurse, she didn't seem to think it would be a big deal for us to see a local doctor; it's Dr. Barlogie who has issues with us seeing physicians who aren't experienced in Multiple Myeloma.
It will be a long few days but we are anxious to see what this next phase of Tanner's treatment will be.
History, despite its wrenching pain, cannot be unlived, but if faced with courage, need not be lived again... Maya Angelou
Wednesday, February 16, 2011
We are still in a "holding" pattern while the insurance people at MIRT are working to get everyone at UAMS that needs to be enrolled in Texas Medicaid.
I was told by UAMS that Tanner will need to have a Medicaid referral before we come back to Arkansas and that it was a "timely process" so I called his PCP's office today and talked to the lady in their insurance office about obtaining one.
She said in Texas you don't have to have a referral for Medicaid and that she doesn't know how you go about doing one and that Tanner will need to call Customer Service and ask them who she would need to call and how she would go about requesting such a referral.
Now, back when I worked for Dr. Miles and filed insurance for his patients, I would have made those calls myself - but they want Tanner to call for them to get instructions. I'll have to be around when he makes the call so that he can give them authorization to talk to me because he won't have any idea what to ask and most likely won't understand their instructions.
They must have had lots of ice in Little Rock also last week because Sandra Wilson in the MIRT insurance department called me last Friday and told me she was just now starting the process of signing everyone up for Medicaid because they had been frozen in. Tanner hasn't had maintenance chemo for over a week now.
Monday, Bonnie (Dr. Barlogie's Assistant) emailed everyone and asked what the status was because, she said, "this kid needs to get up here as soon as possible". Hopefully this all won't take too much longer.
I'm just ready to find out what the next phase is so that Tanner can start to move on with his life. He can't keep living in this holding pattern of waiting to see if he's going to have to have surgery on his leg or not.
A bit of good news, though, the Make A Wish Foundation called me and he has been granted his wish to go to Hawaii. They will be sending us to Uahu, (she said that's where they send everyone who "wishes" for Hawaii) for a week some time this summer. They've given me possible dates in May, June, or July and will let me know when the exact date is all finalized.
He's quite excited!!
We loved with a love that was more than love... Edgar Allan Poe
Wednesday, February 9, 2011
I've received emails from Dr. Barlogie and Bonnie from the Myeloma Institute for Research and Therapy in Little Rock and they are in the process of getting the doctors who need to be involved in Tanner's treatment signed up for Texas Medicaid before they reschedule him to return for his restaging tests.
So, in the meantime, he is getting a break from any treatment right now.
I just got a text from our friend Shirley and she had her restaging tests done this week at UAMS and the doctor told her this morning - no signs of Multiple Myeloma anywhere in her body! Yay!!
Now we just pray that Tanner receives the same news when we get there!
Don't part with your illusions. When they are gone, you may still exist, but you have ceased to live... Mark Twain
Friday, February 4, 2011
|Box seats thanks to Donna and Paul|
I received an email from Dr. B's assistant letting me know that UAMS accepted Texas Medicaid and that it would be accepted just like if Tanner was receiving his care in Texas. I emailed back and asked her if she thought Dr. Nicholas (the Orthopedic Oncologist that Tanner has been seeing for his broken leg) also accepted Texas Medicaid and she said that coverage was "campus wide" and that everyone at UAMS participated.
At this point I don't know if we are going to Arkansas next week or not.
In the meantime, the Multiple Myeloma Research Foundation has some information on their website about a cancer clinic over at Baylor Hospital in Dallas that treats MM patients so I emailed them and explained a little about Tanner's case and am waiting to hear back from them. From what I could ascertain from their website, they do accept Medicaid so I'm hoping they might be an option for cutting edge treatment here locally.