Hello all,
I am new to the forum and wish I joined years ago. A little about me:
Age:28
Surgery Date: January 2015
Surgery Method: Subocciptial Right Ear
Size: 2.5 x 1.8 x .05cm in aggregate
Hospital: NY Presbyterian Columbia Medical
Surgeon: Michael Sisti
Post-op check up #3: 08/10/2016 (tumor may be growing, will revisit in next check-up)
Post-op check up #4: 03/20/2017 (tumor has grown +/- 1/4" since surgery and will require gamma knife)
Since surgery, my job changed am now living in Massachusetts and my new insurance, Tufts-Advantage HMO, does not cover Dr. Sisti. I've spent the past four weeks trying to work the system and figure out a way to get Tufts to cover Dr. Sisti. This has included several frustrating conversations with member service representatives and supervisors which recommended that I have my PCP send in a referral which sounded very promising at the time, but today I found out the referral was denied. I don't think my PCP or NYP Columbia submitted a strong case or a strong reason why care should be continued. Maybe I am at fault for not specifically asking them to put together a comprehensive request as to why Sisti would be the best fit for the continued treatment, at least in my eyes. Either way I think that at this point with the regrowth that has occurred is significant and I should start looking for recommendations for doctors in Massachusetts that perform Gamma Knife. Does anyone have any recommendations?
Thank you so much in advance.
