Wednesday, October 3, 2012

Denied (sorta)

Mom and I had an smooth and uneventful drive and flight from St. Louis to Houston. Moh has picked us up so frequently that he knows us and no longer stands with a 'CORCORAN' sign at baggage claim in Bush International Airport. We arrived at The Rotary House and had dinner at the restaurant here. Mom ate her last meal for 20 hours (chicken salad with oil & vinegar - very blah due to her supposed PET scan today). We were exhausted and in bed asleep before 9 p.m.

This morning was very early: Mom had a PET scan scheduled for 6 a.m. Or at least she did yesterday. After we walked a mile or so and through a 'restricted' area, we arrived at the PET desk at 5:45 a.m. and were told that her scan had been rescheduled for 12:30 p.m. this afternoon. Frustrated and tired, we retreated back to our room (and through the 'restricted' area again) to return to bed.. We (mostly me) slept until 9ish, and then went to the lab so Mom could have bloodwork performed.

At 12:15, we were back at the PET desk and were informed that Mom was not scheduled for a PET scan at all. She had been scheduled for a CT scan instead. We were dumbfounded. I called Dr. Javle's office and was told that Dr. Javle and his PA are not in the office today, and his scheduler was out to lunch until 1. So, we walked up to the appropriate floor and Mom drank the barrium to prep for her CT, while I went downstairs to sort out her changing appointments and scans.

After two hours of talking to everyone I could get on the phone and leaving messages for those that I couldn't, Dr. Javle's scheduler apologized for not calling to tell us that Mom's appointment was not at 6 a.m. (she thought Mom knew?!?), and Mom's "Patient Access Specialist" informed me that her secondary insurance had denied payment for this PET Scan. In turn, Dr. Javle changed the needed test to a CT scan of her head, abdomen, and pelvis. Mom's secondary insurance denied that, too. So she ended up having a CT scan of her abdomen.

Denial to pay for a PET scan happened in March, as well (unbeknownced to us), but Dr. Javle appealed it and it was approved. Obviously, he's more aware of the insurance workings than we are. He likely picks his battles and knows at which intervals a PET scan is more valuable than a CT scan. Interestingly enough, if Mom had only primary insurance (one type, not two) the PET scan would likely have been approved. I believe insurance will never stop baffling me - and I have been attempting to understand Mom and Pat's insurance for a long while now.

We were planning to go to the Rice Village to shop today, but Mom's appointment lasted until 3, and the barrium stuff she had to drink made her feel sick. So we've ordered pizza and are planning to stay in and watch the Presidential Debate tonight!  It's over 80 degrees and sunny in Houston, though we haven't been able to enjoy it much. Hopefully we will take a walk this evening in the gardens.

Mom's appointment with Dr. Javle is at 9 a.m. tomorrow morning, and Moh is picking us up at 10:45 to catch our 1:15 p.m. flight back to St. Louis. We will likely post when we get through security at the airport.

Keep sending your prayers/good thoughts & vibes Mom's way!

Written/Posted by Jenn.

1 comment:

  1. Oh, my. What a mess! I hope things go more smoothly from now on. Prayers continuous!