The Insanity of Health Insurance

I am being treated at a top-notch research facility. After my recent scans, my case was presented to the Tumor Board at Barnes/Wash U to determine the next course of treatment. This team of amazing physicians decided to continue the same systemic treatment and use gamma knife on my new brain tumor.

Before any services can be provided, a prior authorization request must be submitted by the medical provider and approved by my health insurance. Barnes/Wash U delayed in submitting my prior auths, but they got them in last week. Guess what?!?

Now the Medical Director of my health insurance company is reviewing my case to determine if they will approve it or not. Yes, that is what I typed. An executive at a health insurance company is now reviewing my case to see if they agree with the treatment determined by the Tumor Board at Barnes/Wash U.

THIS IS PURE INSANITY.

So Barnes just called me to say they are canceling the brain MRI for tomorrow because they don’t want to do it until they know for sure I will have the gamma knife treatment on Thursday. IF the pencil-pusher at my health insurance company decides that the Tumor Board at Barnes/Wash U knows what they are doing (?!?!?!?) and approves the gamma knife before Thursday, I will have the brain MRI in the morning, then wait for the gamma knife procedure to be programmed and set up by my neurologist and radiologist, and then have the gamma knife late in the same day.

So I need big prayers that the Medical Director at Health Alliance will approve what my medical team at Barnes/Wash U wants to do by the end of the day tomorrow.