This journal is about my journey with DCIS which began in January 2024. Ductal Carcinoma in Situ. A form of breast cancer. I didn't tell many people. Family, a handful of close friends. I didn't even tell my bosses at the museum where I teach. Somewhere along the line after much prodding and poking, I decided the My DCIS Journey was too boring so retitled the journal Adventures of the Poor, Little Boob.
The Poor, Little Boob has been cancer-free since June 0f 2024, and still has another year of taking hormone therapy and being monitored by an oncologist. My target date for ending the medication and this journey is June1, 2027
 |
The referral and whether insurance would cover treatment at Dana-Farber was becoming a lefthand not knowing what the righthand was doing. Dana-Farber new patient in-take said no referral was needed. The medical group where my primary care physician worked denied a referral. The surgeon at Dana-Farber wanted a referral. I was told to call the insurance company and to ask for an Organizational Determination.
I spoke with the insurance company representative located in Iowa and I told her my sad, tale of woe. I told her the reason I chose Dana-Farber was because they are the only facility in the Northeastern U.S that has a program specifically geared to Ductal Carcinoma in Situ. I could get good care in any facility across the Commonwealth, but at Dana-Farber I would benefit from their decades of research in DCIS. All they treat at Dana-Farber are cancers. Not only would I be treated medically/physical but I would be supported emotionally as well.
I was on hold off and on with the representative for over an hour as she consulted with her superior. At the end of the conversation she was very nice and said she couldn't say for certain, but she thought there would be a favorable outcome.
The funny part was I should have been worried about the cancer, the surgery, and treatments, but I was not. The back and forth from the doctor's group, insurance company, and Dana-Farber was giving me migraines.
The call for the Organizational Determination happened late Friday afternoon. I was told the answer could take 3 or so business days even though the representative said she expedited the paperwork.
I channeled my friend, Teague's oldest brother. He used to say, "Why can't everything be easy!" Only I added a language flavor modifier.
What would we have to bitch about if everything was easy?(not to mention.....if everything was easy, when could I use my colorful words??????)
ReplyDeleteYou can always use a language flavor modifier 🎃
DeleteYou said it was a funny thing... i don't think it was very funny at all.... not even sad.... just 'effin' wrong!!!!! :) Hugs! deb
ReplyDeleteI meant funny as in odd. so odd, sad, funny as you said effin wrong.
Deletethe BS that goes on with the "non surgery " ( insurance etc. ) is enough to give a person a F'in stroke....on a lighter note...your page background is awesome !!! ☺☺♥♥
ReplyDeleteHalloween Ink
DeleteNo wonder you were getting very unwelcome migraines with all the back and forth going on from the doctor's group, insurance company, and Dana-Farber!!!
ReplyDeleteAll the best Jan
It was so frustrating that no one had the answers
DeleteI love the last drawing, and wish it was true. Talk about a pain in the you know where with the referrals. It would be so nice if the medical community could straightened out the system without insurance companies involved-except to pay of course.
ReplyDeleteI don't think the system will ever get straightened out.
DeleteRemind me to never get sick, especially in Massachusetts.
ReplyDeleteThis is not a Massachusetts problem, but a problem with the healthcare system across the country. My issue was the insurance company we had was an HMO, Health Maintenance Organization. Meaning everything under one roof. You need care, you go to their facilities. I wanted to be treated by a facility outside of their circle. That was the issue. The same fight would have happened if I lived in Kansas.
Delete