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Saturday, November 16, 2013

An update

I apologize for not posting sooner. This is what I found out yesterday after speaking with a gal at MDA and two customer service reps at my insurance.

Apparently, MDA sent a pre-determination letter to my insurance a week ago Wednesday. Pre-determination means the insurance will decide if they will fully cover necessary expenses, cover a percentage of the expenses or cover nothing at all. MDA called my insurance yesterday when they had not received word of my approval over the past week and a half. My insurance said they never received any documentation from MDA . . . curious. So, MDA faxed the necessary documentation to my insurance (again) which they received and put in the system yesterday afternoon marked "urgent."

Normally, approval takes 10-12 business days but since my treatments have been marked as "urgent," my insurance is supposed to reach a decision within 72 business hours. I called the insurance and pled my case (in tears, no less) as well as the medical necessity and effectiveness of stereotactic radiation for my kind of cancer. However, the insurance reps said there was no way the medical board would come to a decision on Friday after having just received documentation that afternoon.

What does all of this mean? Because it is a pre-determination issue not an issue of pre-approval, both my insurance and MDA encouraged me to go ahead and start my treatments.

So, we are on the road to Dallas (and then on to Houston tomorrow) planning on doing the 1st two treatments (one on my T2 and one on my L2 vertebrae). At that point, we pray we have word from the insurance of my approval. (Actually, I am praying we find out Monday.) And don't worry, I will be following up Monday and continuing to make sure they know they have a very persistent, concerned customer on their hands. My radiation oncologist, Dr. Brown, is also more than willing to talk with the medical director at the insurance company to convey the medical necessity and urgency of these treatments.

We walked down this road in June with my first stereotactic radiation treatment, and after Dr. Brown's phone conversation with the insurance, it was covered in full. I realize, we are dealing with five very expensive radiation treatments, but I am hopeful God will give me favor as the insurance company reviews my case.

I keep going back to all of the miraculous answers to prayers God provided at MDA over two weeks ago. He allowed us to get in to see Dr. Brown without an appointment, approved all three infected areas for stereotactic radiation and even got my pre-imaging done two days later. It seems almost crazy that He would close the door now after opening so many.

However, I know quite well by now that I am not God and His ways are above mine. (Trust me, if I were in charge, we'd be decorating a Christmas tree instead of driving to Houston this weekend.) He has a reason and I hope it is bigger than seeing how high my blood pressure can rise.

Thank you a hundred-fold for standing in the gap as we wait to see what the Father does. I was reluctant to share anything about this debacle on the blog or Facebook, but I felt like my prayer warriors have been such an incredibly integral (and faithful) part of my journey, I just knew I needed you. I have received so much support and encouragement in the past 24 hours. I don't deserve your love or your continued prayers, but know, I am so grateful.

I have been thinking about a song I learned as a child and was recently brought to my attention by a dear friend who shared it in a card she sent. Thank you for the timely reminder, Janice. The lyrics to the song are below. It also makes me think about Proverbs 3:5-6. This is just another opportunity to trust Him with all my heart and lean not on my own understanding.

God Will Make a Way

God will make a way when there seems to be no way.
He works in ways we cannot see.
He will make a way for me.
He will be my guide, hold me closely to His side.
With love and strength for each new day, He will make a way.
God will make a way.

In closing, as I was reviewing my BSF notes this morning, I was challenged by an application question. "What do you fear?" The challenge was to ask God to protect you and to keep your focus on Jesus. Continuing with this challenge was the reminder when Christ is the center of your life, you will find Him close and powerful. And with this closeness comes the assurance He will work through your present crisis to build your faith in His authority and give you peace.

Lord, you know my fears - all of them. You know how they have only intensified with cancer. You know my heart and my desires. You know my weaknesses and You know how much I can handle on this journey. Help me keep You as my center, even when the crisis swirling around and within me seems unstoppable and ominous. Help me rest in Your peace & expectantly await your power, in your ways, in your time. In Your name and Yours alone I pray. Amen.

3 comments:

  1. Dearest Kelsey: You have said/writtien it all. What more can I say - except we continue to support you in prayer and in love. You are such an AWESOME CHRISTIAN lady and a beacon of light for us all. We stand with you!!!!!!! In Christ, Sharl and Doug Taylor

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  2. I know you don't know me, but as a Sister in Christ, I will be standing in the gap for you. Deut. 31:6
    Amy G

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  3. Kelsey – I have asked the staff at the BGCO and its affiliates, along with many state pastors and staff members to be praying today specifically for the insurance to completely approve treatment.
    Eph 3:20

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