Thoracentesis, COBRA, and Referral to Duke Cancer Institute

Thoracentesis: September 6, 2018, would have been her next day for chemo, but since the CT showed it wasn’t working, she didn’t have that. She did, however, get to have another thoracentesis. They took another 3 liters off her right lung and sent a sample to Cytology. As a reminder, that’s about 7lbs.

Teresa’s last day of work was August 25, 2018, but her employer policy became inactive on August 24, 2018. We didn’t find that out until September 6,  when she went to have the thoracentesis, and we had to sign a self-pay guarantee for not having insurance.

I called BCBS TN and they spoke with the woman registering T in Radiology. Once COBRA was elected and the policy reactivated (with no lapse in coverage dates), we would be able to calling billing and have them resubmit the procedure.

I guess the policy retro-deactivated on the 24th when BCBS received the termination date (from K-VA-T) on September 5th, because we didn’t have to sign a self-pay agreement for her CT on August 31. That’s a relief too, since a CT costs a LOT more than a thoracentesis. (CT runs about 7K.) 

In any case, we were told we would get the COBRA forms in about 2 weeks.  Which wasn’t a long time. But this abruptly became a problem when the wonderful women at the Wellmont Cancer Center worked to get Teresa an immediate referral for surgery at Duke Cancer Institute (North Carolina) and Duke said they couldn’t accept a referral for a patient with an inactive insurance policy.

I woke up to a voice mail about this on Friday. I called* the direct COBRA number I’d been given the other day. Long story short, I got them to expedite the processing from 2 weeks to 24-48 hours, and they would send me an email with the enrollment paperwork by end of day Friday or Monday.

I got them Friday. I read them to Teresa, she signed them. I scanned them to my computer (into a PDF) and emailed them back. Then I called to make sure they got them, and then paid for the last week of August and the full month of September. 

Since it was end-of-day, everything, including the payment, still has to be fully processed, but the latest the policy will be active again is Wednesday. And, the second wonderful COBRA rep I spoke with said that I could give anyone from Duke the direct line, and they would verify that the policy was processing – and paid for – and would be good to go very soon (if it isn’t already come Monday morning – they’ve put a rush on it).

Duke Referral: The upshot is that Trish at the Cancer Center explained our situation, and that we would be electing COBRA for Teresa, and the policy would re-activate, and I was trying to get BCBS to expedite the enrollment process.  They (Duke) were understanding, and the (I believe assistant) for the doctor we want to see (recommended by another LMS patient I met online) is going to call me Monday morning.  When Trish told me that, I didn’t yet have the enrollment forms, but once I got them Friday, and got them back and paid, I knew I had a really good shot of Duke getting T registered.

And, since Duke is on the Epic system, they already have the majority of Teresa’s records!

Trish told me that she was told that I should get a call Monday morning from Zack, and I could update him at that time about COBRA. And, that it looked like they did have openings next week (if I understood her correctly). So….. it’s possible that Teresa could be seen at Duke sometime this week …. and hopefully get the operation she’s been wanting since September 2017. 

We don’t think she can wait much longer.

CT note: The CT results are long, so I will be putting them in a separate post. Most likely sometime this evening. And as soon as I know about Duke, I will write another post about that.
* I know that several of you have been told I don’t like making calls, that the phone stresses me out, and so forth. And now you read here about me making all these calls. I’ve not been lying to get out of phone calls. The phone truly does stress me out, often to the point of cold dread when I’m on the phone, with some exceptions for people I actually know or if I’ve told you I find you easy to speak to on the phone. And I have some hearing loss which makes it all harder.

But what stresses me out way more than being on the phone is the idea of not having my Teresa around, and I will call anyone as often as needed to get things done so we can get her where she needs to go. So if I tell you it’s too stressful for me to be on the phone, know that (1) it really is, and (2) I’m saving up all my spoons for phone time for getting Teresa everything she needs. Thank you for understanding.

Leave a Reply

Recent Posts

Posts From the Caregiver