Wednesday, July 16, 2008

what a tangled web we type

Sure enough, I got my little five page letter from Kaiser explaining to me why they turned down the procedure my doctor had not requested. Right there in black and white they spelled out that I don't need a full body PET scan, not the thoracic scan we're trying to get. On the one hand, they got it right. If we'd asked for a full body scan, it shouldn't be approved because it's not needed. But on the other hand, they should have corrected the typo when Dr. Lee called in to explain that what was denied was not what she'd requested. Literally, someone goofed and checked the wrong box.

But no. The reviewing physician at Kaiser (whose name, address, and phone number are in the denial letter!) apparently understood Dr. Lee's request and that a clerical error had been made but still turned down the procedure... the correct procedure.

Que?

Denise's advice is to go ahead and start the appeal process. I'm not quite sure how I'm going to convince the Kaiser doctor if he has already heard Dr. Lee and still said no. But I'll try, I guess. At the minimum, the CT scan I just had done will probably come back inconclusive giving Dr. Lee another reason to ask for a PET scan. A thoracic PET scan. My very first CT scan was not revealing and that was while the tumor and mets were untreated. Seriously, Kaiser... duh, much?

So I'll do that today. And I'll ping Dr. Lee to see if she'll write me a letter for Lockheed to take me back on the payroll. And I'll call some tree guys after my county environmental guy visited on Monday. And I'll take a whack at cutting the grass; slowly so I don't keel over. And I'll whittle off some lighting fixes for the house. And when it gets hot, I'll retreat to the air conditioning and fight with Mom's dying laptop to rescue her pictures. And I'll have to work in a trip today to make sure we have dog food. Ahhh... tedium... ;)

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