09/12/2018: I Discontinue the Opdvio/Nivolumab Study

08:30:  I call my research nurse Deborah and ask her questions about the study.

The main reason being is that MD Anderson has been saying they have been getting preapprovals and doing everything right, but the insurance company just isn’t pay at in network levels, like the insurance company said they would and the insurance company points their finger at MD Anderson for not getting the approvals done correctly.  It’s a big mess. So I am done running up a bill at MD Anderson.

To date they say I owe $5,513.19.

I have been going back and forth with them and my insurance company.  Everything was covered up fine for the first 3 months, and then issue after issue with insurance saying that MD Anderson is just scheduling these without getting the proper authorizations, therefore everything is process at out of network levels when they should be processed at in network levels if authorizations were being done correctly.  Insurance went back and corrected what they could, but they stopped because they can’t do it for every visit, MD Anderson needs to do it correctly to get paid.  However something is getting messed up and MD Anderson is still billing me.

I ask my research nurse, as the study said, it would pay for the scans, however the nurse says this far out, the study is not really paying for anything because it is not study mandated scans, and I have been in remission long enough that the study doesn’t really need me anymore, and if it was her, she would stop doing the study and just have the study follow up by phone every three months on my health, and see if there were any long term side effects and to start seeing my local doctor.  The study has the numbers they need from me, not much more I can help the study with.  That makes my decision easier.  I am going to go back to Dr. Safah at Tulane University for my follow ups, in network with no issues, and everything is done in Louisiana again.  No more 1 or 2 day trips for now.  So that is the reason I am done.

She says she will remove me from the study, and cancel all upcoming appointments.

If someone out there wants to help me pay what I owe to MD Anderson, feel free to click that donate button at the top right of this blog, otherwise they are not getting a dime out of me.

You pay insurance for a reason, and when the proper protocols and ways of doing things and frequent request to flag my account to process my preapprovals a certain way and to make sure everything is covered goes ignored, that is not my problem but the providers problem.  I am not paying for what was their fault to do what I told them to do to get everything paid in network.

I spent too many hours, phone calls, and time trying to get to the bottom of it.  Only to be told not to worry about it, it will fix itself, told that they would look into it, and multiple times I had my phone calls, I said calls, calling back 2, 3, 4 times by multiple departments including Patient Service, a Patient Advocate and the Financial Clearance Center to never have them return my phone call.  It seems they wanted to help, but once they looked into my situation, no one would ever call me back or further my investigation into why everything was going on.  Multiple departments left me hanging.  What was I right, and them wrong, they just never decided to get back to me, but ignore me.  Impossible.

So for now I am done with MD Anderson.  Back home for follow ups and scans and tests from now on.

© Craig