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Dupuytrens RT in the USA
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02/27/2011 02:53
Diana 
02/27/2011 02:53
Diana 
Re: Dupuytrens RT in the USA

My radiation was approved by Health Net. I had it done in 2009.

Diana

02/28/2011 00:08
lauriw 
02/28/2011 00:08
lauriw 
Re: Dupuytrens RT in the USA

thanks for the reply. where did you have your RT? Who was your doctor?
LauriW

03/02/2011 20:56
GTilford 
03/02/2011 20:56
GTilford 
Re: Dupuytrens RT in the USA

Hi all,

Its been awhile since I started this thread, and much has transpired in my experiences with RT in the USA. First off, I went to Bozeman Deaconess Cancer Center in Bozeman, Montana, where I met Dr. Koeplin there. He is a very nice man with a very solid, well informed and positive attitude toward the use of RT against Dup. It is apparent that his willingness to administer RT comes from what he has learned from the work of Dr. Seegenschmiedt in Hamburg--- as I would expect of most American Radiologists--- and Dr. Koeplin's treatment protocol, at least in terms of radiation dosing, frequency etc. is essentially the same as the German protocol. However, to date he had done only 7 of the procedures, and I left the center with doubt about his abilities to detect early stage nodules that are not obvious to untrained senses, and of how accurate the RT might be. Not that any of this mattered--- about a week after my appointment I was notified that the pre-authorization request which had been submitted by Dr Koeplin, to Blue Cross Blue Shield of Montana, was promptly rejected on grounds of this being an "investigative" procedure. This, despite the fact that Dr. Koeplin has treated Dupuytrens patients before; with approval from BCBS. My intent is to appeal, but only for the purposes of supporting others that are currently sparring with their insurance carriers. We need to change this--- RT is not[i](at least in my mind) a preventative treatment. It is a remedial, potentially short lived opportunity to STOP what is already diagnosed and progressing.[/i] So... I am now off to Hamburg for treatment on March 17th. For those who are struggling with the decision of whether to find RT in the USA or to bite the bullet and buy a plane ticket, I have these insights and opinions to offer... First, it is clear that the world's experts on RT for Dupuytrens are in Europe. From all I can gather, including journal papers published by the National Institutes of Health (USA) and others, most of what is driving USA radiologists to perform this treatment comes from respect for what Dr. Seegenschmiedt has revealed by his work in Germany. Second, even if you do have insurance that will cover this in the USA, I recommend that you crunch your cost numbers carefully. There will be out of pocket expenses like copays, deductibles and travel expenses if the clinic you find requires a long drive or flight. In my case, if BCBS came on board with a 50/50 copay, a maximum out of pocket deductible of $3000, and with expenses for hotel, etc. (two 5 day rounds of treatment, 200 miles away), the cost of my covered[i] treatment would be in the neighborhood of $5800. A trip to Germany on the other hand, where RT costs approximately 500 euros per target and airfare is about $1000 per trip, the whole enchilada will likely cost me somewhere around $9000 all said and done. Couple the numbers with the fact that this is my right hand (I [i]really[i]need it)[/i], and the price of going to the world's leading expert starts making alot of sense.[/i][/i]

03/02/2011 21:37
Larry 
03/02/2011 21:37
Larry 
Re: Dupuytrens RT in the USA

Aren't Hand Surgeons and the Doctors from Radiotherapy share the same philosophy ?!

Both groups of doctors declare they want to help the patient by preserving the function of the hand(s)!

However, there is only a fine difference ....

Radiation therapy can be done earlier (with no loss of function at all)

Hand Surgery requires a dysfunction or a disability to stretch your fingers ...

So what the hell is the health insuarance doing with women breast cancer ??

Early screening, early treatment, early effects to AVOID LONG-TERM costs !
Shouldn' this apply to ALL other early forms of disease similarily ? Good success with your appeal to BCBS.

Larry

Edited 03/02/11 23:39

03/02/2011 23:29
David26

not registered

03/02/2011 23:29
David26

not registered

Re: Dupuytrens RT in the USA

From all the recent reports, it sounds like BCBS may have made an internal decision to no longer cover RT for DD. If anyone has any knowledge of a BCBS payment in 2011, please respond. That would be helpful.

There have been recent posts on BCBS and Medicare problems with payment and several U.S. medical websites have removed comments that supported RT as an optional treatment for Dupuytren's. Hopefully, we are not taking a step backwards here.

03/03/2011 06:34
LubaM. 
03/03/2011 06:34
LubaM. 
Re: Dupuytrens RT in the USA

David26:
From all the recent reports, it sounds like BCBS may have made an internal decision to no longer cover RT for DD. If anyone has any knowledge of a BCBS payment in 2011, please respond. That would be helpful.

There have been recent posts on BCBS and Medicare problems with payment and several U.S. medical websites have removed comments that supported RT as an optional treatment for Dupuytren's. Hopefully, we are not taking a step backwards here.
Hi David,
There is another thread on this forum:
"RT in the US for DD and insurance companies"
that has discussion about insurance non-payment. I think the key to making changes is getting Medicare to approve it. Usually (for those of us over 65 that have Medicare)...Blue Cross will only pay after Medicare pays as primary. We need to have Medicare pay like they use to !!!!

Flojo (Flora) is working on an appeal with Medicare.

Edited 03/03/11 10:04

03/03/2011 12:37
David26

not registered

03/03/2011 12:37
David26

not registered

Re: Dupuytrens RT in the USA

Luba, I can't get the link to work?

03/03/2011 17:01
LubaM. 
03/03/2011 17:01
LubaM. 
Re: Dupuytrens RT in the USA

David26:
Luba, I can't get the link to work?
David,
It is not a link....I was just referring you to another thread on this forum so that you can read more posts about insurance coverage.

Luba

03/03/2011 17:28
Sentinella 
03/03/2011 17:28
Sentinella 
Re: Dupuytrens RT in the USA

LubaM.:
David26:
Luba, I can't get the link to work?
David,
It is not a link....I was just referring you to another thread on this forum so that you can read more posts about insurance coverage.

Luba
I have Regence Blue Cross Blue Shield in Skagit County, Washington State. They approved my RA in October 2010. I don't know if they still are approving NA for these diseases. I know my medical plan has changed a lot this year, higher deductables, and a higher co-pay. Medical expenses have increased so much in the last year everyone is having to tighten their belts.

03/07/2011 18:53
lauriw 
03/07/2011 18:53
lauriw 
Re: Dupuytrens RT in the USA

I just found out the I have won my appeal with BCBS of Iowa for my RT for DD. I worked very hard on this and did my homework. We need to keep the pressure on and help each other to get this covered. No one should be denied treatment.
LauriW

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