This morning started out at the medical group so I could get my PET CT and CaT scans done. The CaT scan looks at, basically, the torso. (The MRI will check out my head.) The PET CT scan works a little differently.

The PET CT scan traces the glucose in my system because the glucose sticks to areas of cellular activity. Although they expect to find it in places like my liver, if it shows up in unexpected places that could mean a cancer site.

When I first arrived they put me in a small “relaxation” room and stuck an IV in my arm so they could use it later. The first thing they put in the IV was a radioactive isotope. I was told they would leave me alone for about 45 minutes because that was the amount of time it took for it to dissipate sufficiently for me to be safe to be around. No, I didn’t glow.

I was given a liter of “contrast,” which is basically something added to water. I was told to drink it very slowly over the next 45 minutes but to leave a half glass. Although I brought a book to read during my relaxation, they really didn’t want me reading. Apparently, any activity shows up in your muscles when they do the scan. So I spaced out and sipped my “contrast.”

They eventually showed up to take me in to have the scans. Since I’ve already been diagnosed with melanoma they were doing a “top of head to toes” scan rather than the normal torso scan. I don’t know which part was which scan. The machine has a sliding table you lay on and it moves you in and out of a big tube. First they gave me the glucose through the IV while I was on the moving table. A kind of a torso scan only lasted a few minutes. Then they did a lower body scan that took about 12 minutes. At that point I had to flip around so they could do the upper body for about 15 minutes. Then I was done. In and out in just over a total of 2 hours.

Down to only one medicated eye drop per day now! Seems a little weird that just one drop does any good and that I’ve had to be weaned off of it. Of course, I’m still on the hourly timer to use the other drops to keep my eye from drying out.

Down to the final day to settle the insurance confusion or to change my CAT annd PET CT scans that are scheduled for tomorrow morning. After spending 45 minutes on the phone with the insurance company, they finally agreed the medical group is a preferred provider. Yea, just saved $3,000!

Got a call this morning from Dr. Opth’s office. They had a surgical cancellation and offered me the opportunity to have my surgery on 11/17 instead of the following week. I had to decline since my whole work schedule is now based on having surgery the week of Thanksgiving. Not to mention that my friend who plans to pick me up after the surgery is on vacation the week of 11/17.

Got a call this morning from the medical group person who’s been helping me try to untangle this insurance mess. She had faxed over the copies of the letters I received to the insurance company’s Utilization Management person but hadn’t heard anything from them. She suggests I contact the insurance company’s customer service again and talk to a supervisor. She said I should mention that the utilization management department believes the medical group IS a preferred provider for my plan.

As it happens, I received a “stay of confusion” because the medical group called me to reschedule the MRI (that was tonight). It appears the original scheduler missed the fact that they are scanning more than one area or something and the missed part requires me to be there during the day instead of the evening. Since I was unable to immediately go over there when they called, we’ve rescheduled for next Tuesday.

I called the insurance company this morning to better understand the letters I received over the weekend. According to customer service, the medical group signed up as a HMO preferred provider but not as a PPO preferred provider. Being astounded didn’t change her mind.

She told me I could always check the insurance website to find a preferred provider. I told her the medical group was on their list and it makes me specify which plan I have when asking for providers. She didn’t have a good response for that but she gave me two other imaging places that were on the preferred provider list.

Then I called the medical group and told them I would need to change where I have the scans done. She said they absolutely WERE a preferred provider for any plan but would check on this. She called me a little while later and asked me to fax the letters to her because she needed to show them to someone.

The medical group called someone in the Utilization Management Department (UMD) at the insurance company and they went back and forth most of the day over this. The UMD person felt that the letters were sent in error and wanted a set faxed to her, too, so she could check them out. By the end of the day, the medical group person helping me hadn’t received anything definitive.

Since my MRI is scheduled for tomorrow, I’m going to have to decide what to do at least by noon. One problem is that I have appointments in the morning and can’t spend the time chasing the insurance company for a decision.

As it happens, I got a call from Dr. Opth’s admin. She said they had a cancellation and I could have surgery on 11/17 instead. However, since my friend who’s giving me a ride is on vacation AND I have my work planned around Thanksgiving week, I passed and kept my original date.

Don’t you just hate it when you get news on a weekend and can’t do a thing about it until Monday? Big bonanza in the mail today. I received a stack of EoB’s plus five letters regarding the scans that Dr. Onc had asked for.

There was one letter for the MRI stating it was approved as medically necessary but that I was using a non-preferred provider so there could be additional financial responsibility. The other four letters were in a similar vein for the CT and PET CT scans.

I was confused about the non-preferred provider part because this medical group is well-known for accepting insurances. At first I was tempted to ignore it because I already know I’m easily going to hit my deductible this year, so what more financial responsiblity could there be?

Okay, here’s today’s lesson. I went on the website to try to figure this out and ultimately found the place where they showed my dedutible, plus my co-pay maximum for preferred and non-preferred providers. The co-pay maximum is $7,000 for preferred and $10,000 for non-preferred. Ouch! Does this mean my total out-of-pocket this year is going to be $12,000-$15,000 instead of the “mere” $5,000 I was planning? It’s on my to-do list for Monday to call and figure this out.

Oh look, my EoB’s show that I’d already reached my $5,000 deductible before the first surgery was even over. Yikes!