Tag: insurance authorization

Why are We Spending So Much Time with Insurance Calls?

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I truly believe this is a question both patients and physicians ask themselves quite frequently; Why are we spending so much time on insurance calls? This week alone, I spent upwards of three hours battling my insurance company to reinstate a medication that has proven to work for me for the past four years and suddenly is no longer covered by them. I found this out at my oncologist’s office recently when I went in to get my Prolia injection. Since my second breast cancer diagnosis in 2014 I have successfully, with little or no side effects, taken this injection to prevent bone loss from the medication I am on, AI, to prevent my cancer from recurring. One of the side effects of the AI is bone loss and why I was prescribed Prolia. The Prolia was working! I was even on their Patient Co-Pay Program greatly reducing my out-of-pocket Continue Reading →

Waiting for Authorization for Breast Reconstruction

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Waiting for Authorization for Breast Reconstruction It can take enormous patience for breast cancer patients who are waiting for authorization for their breast reconstruction procedure. I was once there. Now I am an advocate for all options of breast reconstruction after mastectomy. I interact with patients daily. Many times, their questions are a catalyst for topics to write a blog. Amplifying our voices to educate is part of patient advocacy responsibility. I recently received an email from a patient who was denied coverage for a revision phase of her reconstruction. Her plastic surgeon even wrote an appeal, but it was still denied. She reached out to me for help and suggestions about what to do. I take a deep breath when I get these emails and step out of my breast cancer survivor role and put on my patient advocate hat. I don’t want to offer false hope, but I Continue Reading →