Insurance Approval and Chest CT

This week’s theme is waiting for insurance approval. The instructions that Roy received on Friday were more a message to be patient than a call to act. Essentially, he has been referred to Interventional Radiology at Methodist to have his Y-90 treatment done but that will not be scheduled until the insurance pre-approves it. This should not be an issue because he has coverage but it takes some time (estimated by his care team to take two weeks). When it is approved, then IR will contact him to schedule.

Roy has also, as expected, been referred for transplant evaluation. He is at the same step there – in that case, the care team expects it to take up to four weeks. Once he is approved, then that team will contact him to schedule. We may be slightly ahead on that one, as someone from that team had already contacted him, and started the insurance/financial approval process a couple weeks ago.

In the meantime, our field trip this week will be for him to have a Chest CT at a Methodist hospital in Houston. We grabbed the quickest appointment we could find which will be on Tuesday afternoon. Why a Chest CT when this is a liver-centric problem? So that they will know if the HCC has gone traveling to other parts of his body. We hope it is still in the liver and only the liver. If it has wandered, that will change how they approach his treatment and his chances of transplant. This is the only concrete appointment he has right now.

We have insurance so treating the HCC and sending him for transplant evaluation should not be a difficult thing for them to approve; we know what the coverage includes and it does include both of these things. I think we are just in that administrative process phase which is subject to the availability of staff and their attention to this particular case. Unfortunately, I don’t think there is any way to poke this along without unintentionally irritating the people handling the work. I get irritated when students ask repeatedly when our team will get their whatever done, so I don’t want to do that to the insurance folks. I have to remember he is not the only patient that this care team has on their plates at the moment (and they’re all liver tumor people) or the only insured person that the insurance company folks are reviewing. I don’t think I am good at being on this side of the desk.

If we’re lucky we will have good weather on Tuesday and see some bluebonnets peering up out of the grasses as we travel.