Rage, Rain, and Red Tape

Denny and I have had quite a day.  I'm not sure if it was a full moon but the odds were not in our favor today.  We left the house at 9:30 a.m. to get to the oncology department for his labs.  They always draw blood to check his levels before administering chemo.  Today was supposed to be the Erbitux infusion.

As soon as we got to the office, Dr. Murphy came in and explained that Denny would not be getting the infusion today because of his insurance.  His insurance is primary and mine is secondary for him.  If his doesn't approve a procedure; mine cannot be engaged nor will it pay either.  Dr. Murphy said her assistant had spent 4 hours on the phone arguing with the insurance and then she, herself, tried to do a peer-to-peer conversation with the insurance doctor.  She said she couldn't start the treatment without precertification because then the insurance would definitely not pay.  The cost for this drug is $20,000 per month.  Nothing got resolved so Denny went without.  At that point, we rescheduled him for tomorrow morning; hoping it would get resolved  sometime today.

From there we went to the Surgery Center at Vanderbilt to have the biopsy done. Strangely enough the insurance HAD pre-certified the biopsy which had been scheduled AFTER the pre-certification request went out for the infusion.  All of the doctors and nurses were very nice and the procedure was over in about an hour and a half.  Denny was done around 5:30 p.m.

While Denny was undergoing the biopsy, I called Dr. Murphy's office again and left a message.  I wanted to see if anything had been resolved before we left the hospital.  His appointment was for 7:30 a.m. tomorrow.  I didn't want us to have to fight Nashville Morning Rush Hour traffic just to find out the insurance wasn't cleared.

Denny came out of recovery and we left the hospital about 5:30 p.m.  Nashville had just gotten a huge downpour and traffic was a mess.  Accidents all over the interstates.  After the day we had, my patience was about at breaking point.  I was trying to hold in the rage because it doesn't do Denny any good to hear me rant.  Between the people riding the bumper and people cutting in front of us, it was close to becoming a "Murder She Wrote" episode.  We couldn't get home too soon for me! 

While we were driving, Dr. Murphy's assistant called and said the insurance still had not approved so there was no sense in coming in tomorrow.  Dr. Murphy had evidently done some screaming as well.  Supposedly the insurance had submitted the paperwork to the precertification area and forgot to hit the "submit" button.  Wow!  Really?  It has been elevated to the highest level because some yo-yo forgot to hit the "submit" button?  Denny has now been tentatively scheduled for Wednesday morning.

I told Denny I would give Dr. Murphy's office until Wednesday to get this sorted out and then I was going to get involved.  Yes, at that point it will be time to drag out the briefcase.  It is sort of a joke in the family that if I drag out the briefcase, it is "lock and load" time.  In other words, I  go into missile mode and lock on until I get it resolved.  I'm hoping Dr. Murphy can get this done because "lock and load" takes a lot of time and energy.  Something tells me she's got a "missile mode" too.  This doctor is one feisty lady!

When we got home, I made Denny some homemade chicken soup because the doctor said he needed something light.  He's sitting in his chair watching TV from behind his eyelids.  It has been a long, long, long day for both of us.

The good things today?  The good things are he didn't have any bleeding issues and has been able to come home; sleep in his own house and eat homemade soup while watching his favorite shows.  He isn't in any pain (thanks to pain meds) and the tumor tissue is on it's way to Boston. 

I'll keep posting as soon as the info becomes available.  Thanks for checking in and if you have the time, please say a little prayer that a solution becomes available.