OK, so every time I have had to arrange scheduling or prior authorizations with my husband's oncologist's assistant, "DP", I have had to phone her over and over and over and over. Since we are going there from out of state, if prior authorization is not obtained, we are responsible for the costs. Otherwise, if this was an in-state procedure, the provider would be responsible for their negligence in not obtaining the prior authorization. I am at my wits' end with her right now. I started the process of asking for my husband to have an MRI instead of CT at least three months ago after my husband had his most recent appointment with his oncologist. Unfortunately, I was unable to be there. His doctor changed the scan frequency from his original "every three months" to "every six months." When we originally met with him and the liver surgeon I asked them what they normally used for surveillance scanning. I recall that it was MRI, and I was pleased because that is also what the liver surgeon in Albany, NY we went to for a second opinion had said. I would have spoken up and questioned at this most recent visit. I did so via email to the oncologist's other assistant, "AG", a Nurse Practitioner who was been totally awesome from day one. I explained to her that I was concerned about using CT because 1) none of my husband's CTs (or the PET) ever detected his liver masses and 2) he takes curcumin which apparently can interfere with the CT contrast. After about a month of emailing about this, the doctor approved an MRI order June 6th. I was supposed to hear from DP but after about a week of waiting, I called DP to schedule the back-to-back appointments for MRI, labs, then oncologist. She actually got back to me relatively quickly, after a few days, without me having to call her repeatedly.
Now, the doctor is only available for appointments two days a week and the follow up is recommended for November. Radiology appointments are not easy to get at Mass General, so all of the time slots that would work for us (midday since we have to travel 4 hours each way) in the month of November were unavailable except one at the end of the month: November 27th. Since prior authorization is needed, a week after the appointment was booked, I started checking in with our insurance company to see if a request was initiated. It wasn't, so I checked in a week later and it still wasn't. I checked in a week after that and it still wasn't. To this date, DP has not started the process.
Maybe it's because I have a Motion for Summary Judgment due October 1st, with responses due October 29th, sur-replies due sometime in November, and a hearing on the motion on December 11th that has me really anxious about this. Or maybe it's because if the MRI is denied, we have to go with a CT, and that means rescheduling everything. Given what an ordeal scheduling can be, I think it is reasonable to expect the prior authorization to be processed as soon as possible.
Before my husband complains to the doctors (no one wants to get on his bad side as he can be vicious), I am ranting here. I am going to take the above, copy and paste it, and finesse a complaint draft for him out of the contents.
Oh, yeah, due to all this BS, I am considering suggesting to my husband that we look elsewhere for follow-up surveillance. I'm wondering what those patients of Dr. Kenemy have experienced with surveillance/monitoring in regards to situations like the above.