Jerry is on his way to his second oncologist appointment (Century City, CA) of this year. I was kinda concerned if he would go today. A few days ago I received a call from PharmaCare. PharmaCare is the distributor of the drug Avastin which is administered through an IV in the doctor's office. PharmaCare said that our insurance (United Health Care) was denying the claim with an "Unqualifying diagnosis". Jerry has been receiving Avastin since March, 2006. I explained to PharmaCare that Jerry's appointment was in two days and that the product needed to be sent immediately. PharmaCare said that they could not ship the product unless I would guarantee payment, that would mean that if the issue was not resolved Jerry and I would be responsible to pay the $16,500.00 cost of this drug. As you can imagine, immediately I contacted our HR/benefits department for assistance in this matter. At the same time, I contacted the oncologist office to tackle the problem from their end. So far there has not been a resolution to this situation, however the oncologist office does have a supply of Avastin, in their office and Jerry will be receiving the drug, today. Once the insurance determines they will cover the cost of this drug, PharmaCare will replenish the oncologist's inventory. If the insurance company decides they will not cover the drug, Jerry and I may be responsible to pay the oncologist for this drug. In the past, these issues have been resolved without Jerry and I having to pay these outrageous costs.
Jerry's oncologist has also ordered a chest (PA & LAT) x-ray at the outpatient imaging center in Century City before his visit today here. Even though Jerry feels he does not need an chest x-ray I am glad they ordered it. Even though Jerry is not as sick as he was, he continues to have coughing episodes and a lot of congestion. He is on his second week of antibiotics.
I will update you on how Jerry does, after his appointment, and how he's feeling for the next couple of days.
Jerry's oncologist has also ordered a chest (PA & LAT) x-ray at the outpatient imaging center in Century City before his visit today here. Even though Jerry feels he does not need an chest x-ray I am glad they ordered it. Even though Jerry is not as sick as he was, he continues to have coughing episodes and a lot of congestion. He is on his second week of antibiotics.
I will update you on how Jerry does, after his appointment, and how he's feeling for the next couple of days.
1 comment:
We will be waiting to hear how Jerry's appointment went with the doctor and the x-ray! Hopefully, the warm Hawaii weather will be just what he needs to clear up the congestion and infection!
Post a Comment