Topic: Denied chemo

I was put on fulfori/ tarceva last Thursday.  The tarceva was denied, now after one treatment they have denied folfiri also.  I have blue cross/blue shield and they want proof that this treatment helps in cc.  They want documentation.
How could they deny this drug? What are my next steps?
Please I need help!there has to be some way to get this. There are many people on this site that receive it.
Jtoro

Re: Denied chemo

Hi,
Please do not worry, your doctor's office personnel will help you to find the documentation that you needed;it is part of their job; all it needs is your doctor to submit the paper works again.
God bless.

Please know that my personal opinion is not intended nor implied to be a substitute for professional medical advice. If  provided, information are for educational purposes.Consult doctor is a MUST for changing of treatment plans.

Re: Denied chemo

jtoro...I am sorry to hear that again your have to battle the insurance companies.  Again, I think that Taline will  be your best resource.  Good luck and please keep us posted.
Hugs,
Marion

THIS INFORMATION IS NOT INTENDED NOR IMPLIED TO BE A SUBSTITUTE FOR PROFESSIONAL MEDICAL ADVICE. YOU SHOULD ALWAYS SEEK THE ADVICE OF YOUR PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROVIDER

Re: Denied chemo

Your doctor can also request a 'peer to peer' review with the regional medical director of your insurance company.

Also they can and should submit any supporting documentation that the drug is helpful in pancreatic / gallbladder / kidney or liver cancer.  Keep pestering the doctor's office to get in contact with your insurance company.

The reason they most often deny is because of the huge expense of these types of drugs.  You can also appeal the denial yourself, however it's best if your doctor's office does the appeal and if necessary a peer to peer review.

It can be done and most often it's possible to get the drug approved.  Hang in there!  Keep us posted.

Margaret