I Hate Dialysis Message Board

Dialysis Discussion => Dialysis: Transplant Discussion => Topic started by: paris on April 20, 2009, 05:55:23 PM

Title: Insurance review
Post by: paris on April 20, 2009, 05:55:23 PM
I got a letter today from the insurance company saying that the IVIg and Rituxin treatments are in "initial review".  Doctor wanted to start them ASAP, but there are always many hoops to jump through.  I wonder if the insurance will approve this.  We shall see. 

Thought I better add that this is to help with getting a transplant.
Title: Re: Insurance review
Post by: Sunny on April 20, 2009, 11:57:01 PM
I hope the treatment is approved for you Paris. Let's hope they don't come up wth some crazy reason not to cover it.
Title: Re: Insurance review
Post by: chris73 on April 21, 2009, 05:16:17 PM
The  insurance  i  have was hard to deal with....I didnt get approved until one week before surgery , my Dr's had to send all my test and labs to my insurance company to make sure i needed a transplant..also i take cellcept they would only approve a 29 days supply but not a 30 day, go figure...Chris
Title: Re: Insurance review
Post by: paris on April 21, 2009, 05:41:43 PM
Good thing is, I have been on transplant list for 3 years and our coverage is very good.  Now we just need to see if they will cover these extra treatments to (hopefully) lower my PRA so I can accept a transplant.   The insurance company is now waiting for the surgeon's explanation of why the IVIg therapy and Rituxin is needed and how often/how many treatments there will be.  So, here is hoping the insurance gods smile on this request.   :2thumbsup;
Title: Re: Insurance review
Post by: chris73 on April 22, 2009, 05:39:40 PM
hope that insurance covers them..its a shame they question wheather you need the treatment or not.. and decide wheather they pay for it or not...
Title: Re: Insurance review
Post by: okarol on April 22, 2009, 06:37:19 PM

As with nearly everything, it all boils down to $$$ and how much they are willing to spend.

Did they say how long the typical review might take?

Keep asking questions. Medicare should cover some of it - have you checked?

I hope you get the treatment soon!

 :grouphug;
Title: Re: Insurance review
Post by: Rerun on April 22, 2009, 11:07:46 PM

As with nearly everything, it all boils down to $$$ and how much they are willing to spend.

Did they say how long the typical review might take?

Keep asking questions. Medicare should cover some of it - have you checked?

I hope you get the treatment soon!

 :grouphug;

Paris is not on dialysis yet so she won't get Medicare.  How does that work when you get a transplant before you are on dialysis.  I guess Medicare would just pay for drugs for 3 years.   ???
Title: Re: Insurance review
Post by: paris on April 23, 2009, 09:02:19 AM
My primary insurance pays and fortunately, we have great coverage.  I think they just want the schedule of treatments, etc.  The treatments aren't new or experimental, so I am hoping their answer is yes.  They readily pay for all the repeated testing to stay on the list.   If someone says something needs to be done, I want to do it now.  I don't like waiting.  It gives me too much time to think!    I am on SS disability, so qualify for Medicare part B, but don't pay for that coverage yet.  I do have part A.   The surgeon has told me to "bug" transplant center every week until we get this started.    And regarding the meds post transplant: my primary insurance pays for the meds. I get a print out once a year about the actual costs of the drugs I would be on and how much my co-pays would be. I am not too stressed about that part.  Just waiting for approval for this new stuff drives me crazy. 
Title: Re: Insurance review
Post by: rookiegirl on April 23, 2009, 02:53:51 PM
Paris - wishing and praying all goes your way.  Thinking of you my friend.
Title: Re: Insurance review
Post by: paris on April 28, 2009, 05:46:15 PM
Got more paperwork from the insurance company today.  I guess they want to make sure no one else is going to be paying for this.  I realized I was getting stressed from the waiting, but just read a great post from Jill D and realize I can't worry about the insurance.  What ever happens, will happen.  So, not going to stress or worry.  Vandie and Wenchie have reassured me about the IVIG and Rituxin -- so I will put it aside and get on with other things.  Thanks everyone for always helping me move forward.
Title: Re: Insurance review
Post by: kellyt on April 28, 2009, 06:10:25 PM
Medicare A and B is what I have post transplant and it is secondary to my Humana for 30 out of the 36 months.  But it has picked up payment for everything so far except for stuff sent to my deductible.  I haven't come across anything that is deemed "not covered", so I can't help you there.

Paris, I would think that it would be to there advantage financially no matter how expensive the treatment may be, because the cost of dialysis is so darn expensive and there is no telling how long you will be on it.  That's why they love transplants.  Lots of money up front, but they save in the long run if all goes well!

I love you and I'm praying they don't deny.  Although, I think your doctor will go to bat for you.  Sometimes insurance companies need a little encouraging before they agree.  They want to know how "important" it is to the patient.  Will they fight for it, blah, blah, blah.

Love you!  Hang in there!
Title: Re: Insurance review
Post by: paris on April 28, 2009, 06:59:17 PM
Thanks sweet Kelly.   :cuddle;   I think, in the long run, it will go through.   And I really like this surgeon.  I am hoping since he is the head of the department, he can help get this approved.   He appreciated that I knew so much about the treatments.  I even told him about IHD and his response was "we hate dialysis too-let's get a transplant".   But, I want mine to go as well as yours!  You have been the rock star of recovery!    I am going to focus on my son's wedding on May9th----that is all the drama I can handle!!   Thanks for you encouraging words   :cuddle;
Title: Re: Insurance review
Post by: kellyt on April 28, 2009, 08:18:14 PM
Yes, we'll hit the ground running after the wedding!    :clap;
Title: Re: Insurance review
Post by: paris on May 01, 2009, 06:28:03 PM
I have spent the past three days calling everyone who might be remotely connected with the insurance company or the transplant team.   Finally, this afternoon, my co-ordinator admitted that "she dropped the ball"!!  In the meantime, the insurance declared the review noncertified.  After hours of calls and taking names, the co-ordinator told me she had faxed all the info the insurance needed.  I decided to make one more call to the insurance people only to find out they had not received a fax.  Another call to the co-ordinator. I asked where she sent the fax--she told me. I tried to politely explain that wasn't the right place or person to send it to.  We had a little "come to Jesus moment" and I know she now thinks I am a pain.  This afternoon, she left me a message saying she had sent the fax to the person I told her to send it to and she had received a reply from them saying my case would go to the Board of Review next week.  Why did I know who needed the information and she didn't?  She did say that I needed to keep her on her toes and I needed to stay on top of things regarding my health.   Oh Lordy---she doesn't know me very well, does she?  I had a great relationship with my first co-ordinator.  She is now the supervisor over all the co-ordinators.  Guess who might be hearing from me on Monday?  Thanks for letting me  :rant;   I'll keep you posted  :thumbup;
Title: Re: Insurance review
Post by: willieandwinnie on May 01, 2009, 06:40:36 PM
paris, Sorry you had to deal with the extra stress. I always jump the food chain when it comes to coordinators. I always go to the supervisor over them and I really don't care who I piss off. I'll say a pray that you hear good news next week and take Kits  :Kit n Stik; to the coordinator.  :rofl;
Title: Re: Insurance review
Post by: paris on May 11, 2009, 05:51:34 PM
Friday I called the insurance "powers that be" and actually talked to the nurse in charge of presenting my case. She told me that my case had gone before the board again (now with all the right information) and they approved the treatments.  Today (Monday) my co-ordinator called to tell me it was approved. The surgeon was out of his office today, but she will talk to him tomorrow and they will have a schedule for the treatments by the end of the week.   Progress----I haven't seen much of that for a long time.  My kids are so excited.  Things were so hectic with all the wedding events this weekend, that I never had time to tell my second son, Adam (it was his wedding).  So, during the Mother - Son dance, as " What a Wonderful World"  was playing, I looked at him as said "they approved the treatments"----he stopped dancing and hugged me and started crying.  I am sure the guest thought it was just a moment we were having and no one had any idea why we were both so emotional.  It was a perfect moment, and one I will cherish.   Now I wait for the schedule.    :thumbup;
Title: Re: Insurance review
Post by: okarol on May 11, 2009, 06:22:14 PM

OMG paris - I am crying too - so sweet to share that good news with Adam, and Susie was with you too.
Congrats on being approved - that's wonderful news!!
Title: Re: Insurance review
Post by: kellyt on May 11, 2009, 06:45:19 PM
 :'(  I'm also crying!  Tears of happiness and joy!  Praise the Lord!  You're on your way!!!  I'll bet that will be a moment he'll remember for a lifetime!  I can't wait to hear your schedule!

Don't relax for a moment!  Stay on their tales!  Do not let them drop the ball again!   :cuddle;
Title: Re: Insurance review
Post by: David13 on May 11, 2009, 06:46:08 PM
What great news, Paris!  So glad to hear this is coming together for you!   :cuddle;
Title: Re: Insurance review
Post by: lola on May 11, 2009, 07:01:16 PM
 :bandance; :bandance; :bandance; xoxoxoxo 2 u girlfriend!!!!!
Title: Re: Insurance review
Post by: monrein on May 11, 2009, 07:03:49 PM
What wonderful news (it is a wonderful world) Paris.  I'm so psyched for you.   :cuddle;
Title: Re: Insurance review
Post by: Laurie on May 11, 2009, 07:07:44 PM
What a sweet way to tell your son. I'm so happy they approved your treatments.
Title: Re: Insurance review
Post by: rookiegirl on May 12, 2009, 07:44:13 AM
Paris - I'm so excited for you. 
Title: Re: Insurance review
Post by: willieandwinnie on May 12, 2009, 07:52:14 AM
Oh paris, crying happy tears for you. Have they told you when they will start them.  :cuddle;
Title: Re: Insurance review
Post by: Wenchie58 on May 12, 2009, 08:04:04 AM
 :bandance;  :bandance;  :bandance;  :bandance;  :bandance;  :bandance;  :bandance;  :bandance;  :bandance;  :bandance;  :bandance;  :bandance;  :bandance;
Title: Re: Insurance review
Post by: paul.karen on May 12, 2009, 08:13:53 AM
 :2thumbsup;

i am HAPPY to read this.
Title: Re: Insurance review
Post by: Sunny on May 12, 2009, 11:46:09 AM
Paris, I am very happy for you. Hearing this leads me to have a little more faith in our health insurance industry.
Title: Re: Insurance review
Post by: paris on May 15, 2009, 04:06:56 PM
Transplant co-ordinator called today.  Treatments start next week!  Not sure of the day, she has to check to see what day they have open and what time slot. The infusion room is at the transplant center, so I am familiar with where I will be.  The surgeon has to "tweak" the treatments a tad because I am not on dialysis and part of the treatment includes about a gallon of fluid. Normally, dialysis would take care of that.   I am not nervous or concerned about the process.  Maybe, in the back of my mind, worried it won't change the PRA, but, if I don't at least try I will never know.      :2thumbsup;
Title: Re: Insurance review
Post by: David13 on May 15, 2009, 04:12:42 PM
So glad to hear that this is progressing so well for you, Paris!  You know we wil all be here and sending you all the positive thoughts and prayers that are possible your way.   :cuddle;
Title: Re: Insurance review
Post by: monrein on May 15, 2009, 04:17:30 PM
Next week is soon!!!   :clap;
Title: Re: Insurance review
Post by: rookiegirl on May 15, 2009, 04:47:10 PM
Paris - thinking of you always, always...
Title: Re: Insurance review
Post by: Romona on May 15, 2009, 06:43:15 PM
Love you Paris! Wishing you all the best! :grouphug;
Title: Re: Insurance review
Post by: paris on May 18, 2009, 02:48:03 PM
Infusions start on Thursday, then every Thursday for month.  5/21, 5/28, 6/4 and 6/11.  I have been researching these treatments and working with three transplant centers and now, finally, they will start.  When our sweet Goofynina died, I had the pleasure of meeting Vandie at the funeral home.  She had infusions, pre-dialysis, received a cadaver kidney and is doing well. (she is being a huge help to me right now)   We know these infusions can make a difference in the PRA.  My surgeon cautions me that the results aren't great, but I am going to prove him it can work!   I am full of trepidation, excitement, nerves ---     I am not concerned about the infusions (well, maybe a little)  but more that I am worried about being hopeful again.  Does that make sense?  For so long, I knew I wasn't getting the "call" and didn't have any new people tested because we knew they wouldn't match.  Now,  the treatments may change all of that.  It was a safe place to be in and now I will go back to the unknown.  Thank you for your support and for listening to my strange thinking process!   Now where is the "stressed" smiley??    :stressed;   :stressed;
Title: Re: Insurance review
Post by: kellyt on May 18, 2009, 06:59:19 PM
My thoughts and prayers are with you on Thursday and always.   :2thumbsup;
Title: Re: Insurance review
Post by: Sunny on May 19, 2009, 02:37:52 PM
Paris,
We are with you every step, so keep us updated. I hope all goes well.
Title: Re: Insurance review
Post by: G-Ma on May 19, 2009, 02:55:12 PM
 :cuddle;     :grouphug;     :cuddle;   
Title: Re: Insurance review
Post by: Beth36 on May 20, 2009, 08:10:42 AM
I am so so happy for you, Paris!! What a wonderful way to tell your son about the treatments!!! I know your family is very excited, nervous, etc....my mom hadn't been on dialysis yet when she had her transplant and the IVIg treatments went well before her surgery. She did have issues with the plasmapheresis after her transplant because it made her have a crazy reaction but all is well....I don't know if your center has access to the drug my mom and another member here took but it's worth a shot. It protects the kidney from antibodies after a transplant...so far, after a year, my mom is doing great!!! I can't wait to read all about your experiences and I am hoping and praying for smooth sailing for you!!!
 :grouphug; :grouphug; :grouphug;

Beth

Title: Re: Insurance review
Post by: pelagia on May 20, 2009, 11:54:37 PM
 :cheer: :cuddle; :guitar:
Title: Re: Insurance review
Post by: Wenchie58 on May 21, 2009, 12:14:15 AM
Will be thinking about you Thursday and waiting to hear your post saying "Well, THAT wasn't such a big deal"!  You're gonna breeze through it!  Much love!  :flower;
Title: Re: Insurance review
Post by: paris on May 22, 2009, 01:16:40 PM
Yesterday was nothing but long!  No problems, just takes forever.  But, I started running a fever of 100-101 last night and still have it. Co-ordinator called this morning to check on me and said fever and headaches can be normal side effects.  She said tomorrow should be much better.  I am still going to Ohio Sunday to see my nephews graduation.  A nephrologist stopped by to "talk" for a moment.  He was fascinated with my PRA being so high due to pregancies.  First patient he was met with that!  How many times have I heard that?   If I could only be so lucky winning the lottery!   You would have all been proud. Not a bit of nerves, just let get it done!!  My husband keeps saying that I handle things so well-------if I do, it is only because of all of you and your knowledge and support!   :cuddle;
Title: Re: Insurance review
Post by: kellyt on May 22, 2009, 01:47:49 PM
I'm so glad it went well.  It was the same way with the IVIG treatments I had to do for the CMV crap.  It took them roughly an hour before they hooked up the IV from the time I got there and then the treatment ran anywhere from 2-3 hrs.  Long and boring!

I can't wait to hear the results.  How many more treatments do you have before we know if it's working?

Love you!
Title: Re: Insurance review
Post by: paris on May 22, 2009, 02:13:55 PM
It took about 6 hours for the treatment, once they started the IV.   I kept watching to see how long it took for the first bottle, so I knew what to expect for the second one. They did increase the speed for the second one.  But we left our house at 6:30am and got home at 3:30.  The next two are Rituxin and that should only be 3-4 hours. Then the fourth is IVIG again. After that, they will test the PRA and we should know 2-4 weeks after the treatments end.  It should make the summer go really fast or really, really slow!

Thanks Kelly   :cuddle;
Title: Re: Insurance review
Post by: willieandwinnie on May 22, 2009, 03:09:33 PM
 :waving; paris, I am so pleased to read that your treatment was only boring. I pray you get good results as you know we will all be sitting here waiting.  :cuddle;
Title: Re: Insurance review
Post by: paris on May 23, 2009, 05:59:28 PM
Can't get the fever to break. Stays between 101-102.  Not going to Ohio for my nephews graduation.  Co-ordinator doesn't think it is a good idea because of the fever.  The infusion went so well, a bit disappointed about three days of fever.  Tomorrow will be better!
Title: Re: Insurance review
Post by: Wenchie58 on May 23, 2009, 06:00:55 PM
Yes Paris...it will.  Any day the sun comes up is a better day!  Hold on, this too shall pass.   :cheer:
Title: Re: Insurance review
Post by: David13 on May 23, 2009, 06:09:47 PM
Paris,  I am sorry to hear about the fever, but it does sound like it is not an unusual side effect.  I am hoping you will be feeling better soon.   :cuddle;
Title: Re: Insurance review
Post by: paris on May 24, 2009, 12:54:10 PM
I am the one that breezes through things and never has side effects, so it has surprised me to be down and out.  I am so disappointed to miss my nephews graduation.  He is the youngest grandchild and I was the only aunt that was going to be there.  My sister is sad, but understands.   Wish Ohio was closer than a 9 hour drive.   :(     Today is better than yesterday, so tomorrow will be even better than today   :2thumbsup;    Good thing is that I feel like posting and I have been awake for three hours!! 
Title: Re: Insurance review
Post by: okarol on May 24, 2009, 12:58:43 PM
I am sorry you missed the graduation but it's important for you to take care of yourself now!
I hope you get through the next treatment with fewer side effects.
 :cuddle;
What are possible side effects of Rituxan?
Side effects may include fever, chills, itching, skin rash, throat irritation or tightness, and cough. Other common side effects may include headache, nausea, upper respiratory tract infections and aching joints.

Title: Re: Insurance review
Post by: paris on May 25, 2009, 11:23:14 AM
Today is better  :yahoo;   Fever is alomost gone.  By tomorrrow, I should be fit as a fiddle   :rofl;  Then I can buy groceries, clean and do laundry just in time for the next infusion   :2thumbsup;   :rofl;   But, I feel much better today  :thumbup;   :clap;
Title: Re: Insurance review
Post by: pelagia on May 25, 2009, 11:36:27 AM
 :flower; I am happy to hear that you are feeling better.  :flower;
Title: Re: Insurance review
Post by: monrein on May 25, 2009, 03:37:35 PM
So glad to hear that the fever is going away.   :cuddle;  Shame you missed the graduation.
Title: Re: Insurance review
Post by: donnia on May 25, 2009, 08:35:23 PM
Paris,

I am so sorry it has take me so long to read and respond to this!  OMGosh!  I am so excited
that your insurance approved this!!!  What a wonderful way to tell your son.  You said you will
never forget it but I am sure HE will never forget it either!!!!  I cried and cried when I read how
you told him.

Insurance companies can be screwie... I am glad you have a good one.

I feel honored to be on this journey with you....{{{Great Big HUGS}}}

 :cuddle; :flower; :cuddle; :flower; :cuddle; :flower; :cuddle; :flower; :cuddle; :flower; :cuddle;
Title: Re: Insurance review
Post by: Rerun on May 26, 2009, 05:25:33 AM
The good thing to remember is that you have already been on the list 3 years, so you are up at the top.  All you need is to get your PRA down so they can find you a match.  Keep that and mind and keep running for the finish line.

                                                   :cheer:
Title: Re: Insurance review
Post by: paris on May 26, 2009, 04:39:48 PM
The good thing to remember is that you have already been on the list 3 years, so you are up at the top.  All you need is to get your PRA down so they can find you a match.  Keep that and mind and keep running for the finish line.

                                                   :cheer:

Thanks Rerun---I sometimes forget I have the time in and am not starting from scratch.        Today I am back to my old self. Swept and dusted, freshened things up and bought groceries.  Tomorrow, I will cook a couple of things, finish laundry and be ready for Thursday.   :yahoo;

Donnia, my son was very excited. He gets back from his honeymoon today.  I got an email from him in Italy asking me to put the infusion info in writing and he didn't like being gone while this is going on.  Thanks for you sweet words.  YOU are at the top of the IHD prayer list right now!! 
Title: Re: Insurance review
Post by: Jill D. on May 26, 2009, 04:55:29 PM
So happy you are feeling better!!!  :cuddle;
Title: Re: Insurance review
Post by: Beth36 on May 28, 2009, 07:48:18 AM
Can't wait to hear how the treatments are working!!! Glad you are feeling better, too....you are in my prayers!
 :grouphug;

Beth

Title: Re: Insurance review
Post by: rookiegirl on May 28, 2009, 11:06:27 AM
Only great things for you Paris.
Title: Re: Insurance review
Post by: Jenabcd on May 29, 2009, 12:45:49 PM
Hi Paris,    "WillieandWinnie" was nice enough to send me to your link here.  I am so glad that you're putting all this out here.  I'm hoping to find out on Wednesday, if they're going to do these treatments on me, because of the high PRA also.   Thanks for keeping us posted;  I'll be following you!
Title: Re: Insurance review
Post by: paris on June 05, 2009, 10:51:43 AM
Had round 2 of Rituxin yesterday.  Both Melissa and Beth were with me, so I had lots of "entertainment"   :rofl;   The infusion went fine.  I have found out the difference between benadryl pills and IV!   WOW!  IV hit quicker and better!  I was one sleepy girl.    Also, they brought a woman into the infusion room who had just been called for a liver transplant.  It was very interesting watching and listening to all that was going on.  Before I left, the operating room called and said they were ready for her.  It really helped me to see the process in real life.   Lots of prayers for her and for the donor's family.   One more round of IVIG, then in 2 to 4 weeks, we will know if the PRA has gone down.    I am tired today, so the plan is to do nothing and rest.    :2thumbsup;
Title: Re: Insurance review
Post by: okarol on June 05, 2009, 10:54:20 AM

I hope it's working - it will be interesting to see your results in a few weeks!
Title: Re: Insurance review
Post by: David13 on June 05, 2009, 10:54:37 AM
So glad to hear everything went well for you, Paris.   :2thumbsup;

I am hoping you get good results!
Title: Re: Insurance review
Post by: paris on June 08, 2009, 04:33:52 PM
I had an email from a friend today asking if I knew yet when I would get a transplant.  It doesn't matter how much you explain things, even a college professor has trouble understanding the situation.    But, she is a good person and I know she means well.
Title: Re: Insurance review
Post by: kellyt on June 08, 2009, 05:40:15 PM
I was wondering the same thing.... when ARE you going to get a transplant?   :cuddle;
Title: Re: Insurance review
Post by: paris on June 12, 2009, 02:13:17 PM
I had the last infusion yesterday.   Something is always going on at the infusion center.  Yesterday, there was a man brought in that had a liver transplant 2 weeks ago.  His hemoglobin was 7.5 (the curtains are thin!) so he was getting a transfusion.  There were so many doctors going in and out seeing him.  We finally figured out that he was a doctor also, and it seems like every doctor at the hospital wanted to see him.   Since I was there from 8 until 2:20, I could "overhear" what everyone else was going through.    Today I have a huge headache and fever so I have been sleeping alot.   Now the waiting begins.  My oldest son, Todd, is so excited and postive this will work.  I am trying not to think about the results.  I don't think "what if" anymore.  I will wait for the results and go from there.   :thumbup;   
Title: Re: Insurance review
Post by: okarol on June 12, 2009, 10:23:13 PM

One day at a time - I am glad you're done for now. Hopefully you can take it easy now and the results will be good!
Title: Re: Insurance review
Post by: paris on June 17, 2009, 03:23:42 PM
This past week has been ridiculous.  103 fevers, pain -- just stupid.  I think I am starting to see the light at the end of the tunnel.  Now, we just wait.  Isn't that what we all do most of the time -- wait   :waiting;   :waiting;
Title: Re: Insurance review
Post by: David13 on June 17, 2009, 03:28:21 PM
I am waiting with you, Paris!   :grouphug;

Sorry it has been so rough for you.
Title: Re: Insurance review
Post by: Sunny on June 17, 2009, 03:30:33 PM
Hang in there Paris. You're right, it is just a waiting game. You have to visualize yourself a year from now when all things will have worked out just the way you hoped. Feel better soon.
Title: Re: Insurance review
Post by: willieandwinnie on June 17, 2009, 04:07:28 PM
 :cuddle; paris, we wait with you, My middle name is "Wait"
Title: Re: Insurance review
Post by: pelagia on June 18, 2009, 06:18:56 PM
just sending a  :flower; and  :bestwishes;
Title: Re: Insurance review
Post by: paris on June 23, 2009, 04:15:56 PM
Co-ordinator called this morning.  July 6th they will do another round of labs and then in a week or so we will know if they infusions worked.  I feel too crummy to care much right now, and maybe a little nervous to hear the results.  I told her about the constant fevers, fatigue,etc and she told me to remember that my body had been through a lot and I also I have kidney failure.  Really -- that isn't gone yet?  I should be over that by now!   :sarcasm;
Title: Re: Insurance review
Post by: rookiegirl on June 23, 2009, 06:37:52 PM
Sending positive thoughts your way Paris.
Title: Re: Insurance review
Post by: paris on July 04, 2009, 04:16:40 PM
I got my first billing statement for the first IVIG.  $20,000!  This is where I have to say how grateful I am for our insurance.   The first 6 months of this year, my bills will be over $100,000 of which we are responsible for $750.   And if these infusions haven't made any difference, I think I feel guilty for all that money being spent by the insurance company.  Monday I go for the antibody blood work.  Then we will know if the money was well spent.   
Title: Re: Insurance review
Post by: rookiegirl on July 04, 2009, 04:26:31 PM
I know it will work, I know it will work, It has to work!
Title: Re: Insurance review
Post by: okarol on July 04, 2009, 07:16:06 PM
 :2thumbsup; Keeping good thoughts here paris!!
Title: Re: Insurance review
Post by: kellyt on July 04, 2009, 08:38:42 PM
I totally understand.  My IVIG treatments for the CMV were about 18,000 each.  If I get CMV my insurance company ought to sue the hospital.  ha ha

I pray the treatment worked, Paris.   :cuddle;
Title: Re: Insurance review
Post by: paris on July 06, 2009, 10:00:30 AM
Went to UNC this morning for the antibody blood work.  I am not good at waiting.  And the only news I have gotten for the past four years regarding bloodwork, has been negative --- I am trying to think positive today.
Title: Re: Insurance review
Post by: okarol on July 06, 2009, 10:28:46 AM
 :thumbup; Keeping good thoughts here paris!!
Title: Re: Insurance review
Post by: monrein on July 06, 2009, 01:06:49 PM
Sending positive vibes Paris.  I'm so hoping this works for you and you get to move forward which is only what you deserve to have happen.   :cuddle;
Title: Re: Insurance review
Post by: Sunny on July 08, 2009, 12:46:33 PM
Thinking of you Paris and praying the treatment worked.
Title: Re: Insurance review
Post by: Beth36 on July 08, 2009, 05:53:39 PM
I hope all is well and you are feeling better!! My mom got very very sick from the IVIg and the plasmapheresis....keeping you in my thoughts and prayers...
 :grouphug;

Beth

Title: Re: Insurance review
Post by: okarol on July 08, 2009, 07:37:57 PM
 :waving; Waiting for news paris, hoping for the best!
Title: Re: Insurance review
Post by: rose1999 on July 09, 2009, 12:02:55 PM
Paris I've been following your journey and just realised that I have been so engrossed in it that I haven't actually posted my own love, prayers and positive wishes. I hope you know I wish you all the best and send you buckets of love  :cuddle; Rose xx
Title: Re: Insurance review
Post by: David13 on July 09, 2009, 12:13:29 PM
I am waiting with you, Paris, and hoping for nothing but the best news!   :2thumbsup;
Title: Re: Insurance review
Post by: paris on July 09, 2009, 12:42:12 PM
Thanks for keeping me company while I wait.      :cuddle;    I have been so excited for Jess, that it has helped me not thing about myself. 

Hi Beth,  I did not expect the IVIG to make me so sick.  I thought I would just roll right through it!  But, anything to help the PRA.  I look to your Mother for inspiration.  Her story helps me look ahead.   :2thumbsup;
Title: Re: Insurance review
Post by: Beth36 on July 09, 2009, 04:58:00 PM
Yeah, my mom had to have an epi pen handy because it was like an allergic reaction. BUT all was well after a few days....I am so happy you are finding some treatment! I'm pulling for you!!

Beth
Title: Re: Insurance review
Post by: paris on July 14, 2009, 03:14:00 PM
Co-ordinator called today. Results are not in yet. She explained it took time and lots of testing.  She said it will be next week before we know the PRA. 
Title: Re: Insurance review
Post by: okarol on July 14, 2009, 03:33:11 PM

Oh the waiting!  :banghead;
I am keeping good thoughts paris - wishing you all the best!! :cuddle;
Title: Re: Insurance review
Post by: Beth36 on July 14, 2009, 03:37:02 PM
Well doo doo....I was hoping for some news, too!!! I am on pins and needles!! Thinking good thoughts for you, Paris!!!

Beth
Title: Re: Insurance review
Post by: Wenchie58 on July 14, 2009, 03:47:26 PM
Ok, Ive been patient and trust me that's tough for me.  How long has it been Paris...the longest it ever took mine was 9 days.  I have antibody testing once a month now....and never more than 9 days.  Where's Miss Kit and her big stick...I think they need a bit of motivation!!  :Kit n Stik;
Title: Re: Insurance review
Post by: David13 on July 14, 2009, 03:55:43 PM
Sorry to hear about the delay, Paris.  I am waiting with you and hoping for the best!   :cuddle;
Title: Re: Insurance review
Post by: paris on July 14, 2009, 04:22:38 PM
It has been 8 days.  Seems much longer.  If they would just give the co-ordinator the results instead of going to the surgeon first, I think I would know by Friday.  But, he is the head of the program, so I am sure he wants to have first look.  My results will effect his total sucess rate, so I know he wants a good outcome.   And as he has reminded me, they haven't had good results with PRA of 100.  I just want to prove him wrong.  I am not waiting for the phone to ring this week.  And if it does, it will be a nice surprise.   I keep thinking positively (especially since Wattle's great news) but I am also very realistic.
Title: Re: Insurance review
Post by: paris on July 31, 2009, 02:27:59 PM
I need to vent.  I have had to call the co-ordinator every single week.  Always some excuse. Surgeon was out of the country, etc.etc.  Today, I called her at 10 am. She said that she and the surgeon were the two on call today and as we talked, she was emailing him regarding my results.  She SAID she would call me back one way or another, to at least tell me something.  It is 5:20 --- that is right ---NO phone call.  Seriously, I have been going through testing for 4 years now.  I am not stupid and I am sick of being last on everyones list ( I should be with Kimcanada!!).  A simple yes or no on the success of the infusions is all I want to know.  I am now wondering if the vials ever got to the lab.  I know the results don't effect their lives and there are people much sicker than I am.  My patience has worn thin, or just worn out.  And now it is Friday, so there won't be any calls over the weekend.  It is no wonder that some just give up -- this part shouldn't be that hard.  Just tell me they didn't work so I can move on.   Sorry, I needed to scream for a minute and no one is home to listen to me!!   :rofl;
Title: Re: Insurance review
Post by: cariad on July 31, 2009, 02:52:18 PM
Oh, Paris, I am annoyed on your behalf! This is awful. Did you tell the nurse coordinator how you are feeling?

I have been in this situation countless times, and I cannot believe how easy it is for nurses and doctors to swear they will call you back immediately and just forget all about it. And it always seems to happen on a Friday, doesn't it?

The next time you talk to the nurse coordinator, if she does not have an answer for you, please just level with her. Something to the effect of: "I know everyone is busy there, but I'm sure you can understand how crucial this one bit of information is to my stress level. I really can't wait any longer; I need to know now." The one-human-being-to-another approach has worked for me in the past. Can't hurt.

Beond that, all I can offer is  :grouphug;  :cuddle;  :grouphug;

Good luck!
Title: Re: Insurance review
Post by: David13 on July 31, 2009, 06:11:05 PM
I'm so sorry, Paris.  You have been beyond patient.  This is well past the a reasonable timeframe for your to have received your test results.  I would call first thing Monday morning and DEMAND your results.  No more fooling around with those clowns!  They either have your results or they don't, and you deserve to know either way.

 :grouphug;
 

Title: Re: Insurance review
Post by: rookiegirl on July 31, 2009, 07:35:01 PM
Paris - I'm so sorry you have to go through the run around and play the waiting game.  I pray you will get your results ASAP.  Thinking you always.
Title: Re: Insurance review
Post by: paris on August 01, 2009, 05:46:49 PM
It really is a silly situation.  I don't like my new co-ordinator.  My orginal one is the co-ordinator manager. So, I think I will call her on Monday.  There is no excuse for 4 weeks to go by without having the results.  The last infusion was June 11th. The bloodwork was July 6th.  I have never waited for any results this long.   I really don't care that the surgeon was out of the country --- wouldn't we like to be out of the country too?    I have made so many calls to Dawn (co-ordinator) -- probably 10 calls and as many voice mails this month.  I thought if I bugged her enough, she would want to give me the results and get rid of me!  Nope, she is just ignoring me now!    Can I ignore the bills from the center?    :rofl;   Oh well, Monday will be here and I will start the calls again.   (because I have nothing better to do than make repeated phone calls!)
Title: Re: Insurance review
Post by: okarol on August 01, 2009, 08:11:53 PM
Post the phone number - we can all start calling!  :rofl;
Title: Re: Insurance review
Post by: rookiegirl on August 03, 2009, 10:27:53 AM
What is going on with them?  Geezz!  I'm so sorry Paris.
Title: Re: Insurance review
Post by: paris on August 04, 2009, 12:59:08 PM
I called the office at 9 am and had to leave a voice mail.  The co-ordinator did return the call around 10.   The delay was due to them running more and more tests.  The results are that there is "minimal" change in the PRA.  Not enough to measure.  They will run another set of tests in October with the hope that the drugs they dumped into me will still keep doing their thing and may still help.   So, it was my birthday yesterday -- not the present I wanted to get!  And Zeke had his MRI yesterday, so it was am emotional day.  Oh well, we gave it a try -- that is all we can do.   Thanks for helping me during this frustrating period.   :cuddle;
Title: Re: Insurance review
Post by: lola on August 04, 2009, 01:47:01 PM
Hang in there Paris :grouphug; :grouphug;
Title: Re: Insurance review
Post by: cariad on August 04, 2009, 02:55:59 PM
Oh, Paris, I am sorry about this news. I will continue to hope and hope that things look better in October.

Take care.  :cuddle;  :grouphug;
Title: Re: Insurance review
Post by: Beth36 on August 04, 2009, 03:05:04 PM
I am so so sorry....I will keep thinking of you..

Beth
Title: Re: Insurance review
Post by: David13 on August 04, 2009, 04:49:46 PM
I'm sorry this wasn't the news you wanted, Paris.  I will continue to hope that those drugs will start working and do their thing.   :cuddle;
Title: Re: Insurance review
Post by: okarol on August 04, 2009, 05:00:06 PM
So sorry paris, it must be very hard to take that news. You know we are all here for you.
I have a friend named Shelly who didn't have good results the first round of treatment, but tried it the second time and was able to recieve a kideny from a friend.
Your miracle will come.
 :cuddle;
Title: Re: Insurance review
Post by: Wattle on August 04, 2009, 05:11:02 PM
 :cuddle;  I am sorry you didn't get better news on your Birthday Paris. I hope the drugs are just "dragging their tails" and it will continue to lower your PRA. Never say never. Maybe you will need another round as Okarol has suggested. The whole process is frustrating. Hang in there. xox
Title: Re: Insurance review
Post by: phyl1215 on August 05, 2009, 04:36:41 PM
Hopefully the treatments will continue to lower your antibodies.  I have my second treatment tomorrow.  They are doing mine differently in the trial I'm in.  I have a total of 4 Velcade IV's, 2 the first week and 2 the second week...then 2 wks. of blood work.  Day 28 I will know the results (end of Aug) if this doesn't work then on to phase two with 1 Rituximab IV, 4 more Velcade treatments and 3 Plasmapheresis.  This cost me nothing except for the meds I have to take at home since it is an experimental trial.  I hated to hear you were so ill with the treatments, I'm praying the first stage will work for me but they told me to plan on having to do the second stage.  I know this has worked on many people and we will be two of them!!!  Keep the faith. 
Title: Re: Insurance review
Post by: willieandwinnie on August 05, 2009, 06:14:14 PM
 :cuddle; Oh paris. We are here.  :cuddle;