Ruth
Securing Important Follow-Up Testing for Cancer Survivor
For cancer survivors, regular imaging tests—e.g., positron emission tomography (PET) scans—can be critical to follow-up care after treatment. In the event that the cancer returns, these scans can detect it so that it can be treated right away.
Ruth had already battled thyroid cancer once. Her doctors worried about her cancer recurring and advised her to have a PET scan, but her health plan denied the claim. Troubled by the denial and scared that her cancer may return undetected, Ruth contacted PHLP for help with her next battle.
PHLP instructed Ruth to immediately appeal her health plan’s denial of the PET scan. Then we began working with Ruth’s doctor to obtain a compelling letter that contained both clinical information and language explaining how the PET scan met the medical necessity standard. This new letter was submitted to the insurance plan as part of the appeal process. PHLP also walked Ruth through the steps of representing herself at her Grievance, giving her legal advice and a confidence boost.
Finally, the health plan reversed their denial. The PET scan would be approved! Ruth was very pleased with the outcome and was extremely grateful for the assistance she received from PHLP. Now, she can focus on working with her doctors to ensure her continued health.
