Insurance: Many insurance companies now have managed care plans. These can be PPOs or HMOs.
If you need to go outside a managed care network for treatment of a rare disease, it may be possible to get the penalties waived. Call your insurance company to find out their policy in regards to these waivers. If possible, get your local doctor(s) or health care provider(s) to write letters to the insurance company in regards to the rarity of your disease and your need to seek medical care outside of the PPO/HMO managed care network.
I believe it is in the best interest of those diagnosed with appendiceal cancer to be seen by doctors who specialize in treatment of appendiceal cancer and peritoneal surface malignancies; doctors who are surgical oncologists and who have experience with debulking surgery and peritoneal chemotherapy if that therapy is warranted.
If I'd seen a specialist who determined I needed no specialized treatment, I would have just gone home and been out less than $1000 in medical and travel expenses. I attribute my own survival, though, to the fact that I was seen by a doctor who had experience with appendiceal cancer and that I had the debulking surgery and peritoneal chemotherapy. I wish for everyone to have the opportunity I had to seek a second opinion by a specialist who has experience with appendiceal cancers, but I also know that requires money for travel in most cases.
This link to a page of the Association of American Cancer Centers lists many resources and organizations providing travel and financial assistance to cancer patients.
A word of advice. Carefully review your medical bills and insurance statements. If you have a friend who is a medical professional, ask them to help you. I personally saved $10,000 by doing some of the things listed below. I had to make a lot of phone calls and spent hours on hold and shuffling paperwork. I also purchased a plain paper fax machine for about $100 (it paid for itself many times over vs. a public fax), but I feel I was well paid for my effort in light of the amount of money I saved. Things to look for and to keep track of:
· Double billing:
o Check your bills and insurance statements to make sure you are not billed for something that was already paid for by your insurance.
o Also check dates to make sure you are only charged once for each service/item.
o Make sure you are not billed for an amount that should have been reduced as an in-network service. For example, your charge for a $200 office visit may be reduced to $150 because of an agreement the provider has with your insurance company. Your 25% co-pay would be 25% of the $150 dollar agreed upon reduced charge and not 25% of the $200 dollar charge in that case. It's better to pay the co-pay after bills have been submitted to insurance and you have documentation of the final accepted charge. If you have overpaid a bill, you can request a refund of the overpayment.
This website is for informational and educational purposes only. Readers are encouraged to confirm the information contained herein with other sources. The information on this website is not complete and not intended to replace medical advice offered by physicians or health care providers. Patients and consumers should review the information carefully with their professional health care provider.
Copyright © 2005- 2010 C. Langlie-Lesnik RN BSN All rights Reserved
Last Updated 02/09/2010 11:26:00 AM