Is this even possible?

Chelee · 12-13-2006, 11:13 PM

Is there, or has there been anyone that has went out-of-network to see an oncologist for there over-all care...yet stayed at the cancer center closest to you for your on-going infusions of chemo or herceptin? (Is this something that is possible?) Or do you have to have infusions where you oncologist practices? I didn't know if this type of arrangement could be made? (The new onc would be a almost a hour drive...but I would like to continue my herceptin infusions where I am at currently which is only 10 min drive.) I was hoping the NEW onc could phone in my infusion orders to my current place? Has anyone ever done this...or heard of it being done? (Sure would be nice.) (Probably no such luck...right.)

Chelee

Cheryl E · 12-13-2006, 11:26 PM

Many years ago, my dad traveled over an hour to see an oncologist at UCLA, but did recieve chemo through his local drs. office. you just need to communicate your wishes with the docs and of course clear everything with insurance. Where are you in so. california?

Cheryl

Chelee · 12-13-2006, 11:38 PM

Cheryl, That is exactly where I was hoping to go...UCLA. I am in Southern Ca kind of close to Disneyland if that helps. With traffic these days it wouldn't be too bad if I was only driving into UCLA every 3 months or so. They have some great oncologist there.

But to finish my herceptin trts, & get my zoladex implants I was hoping I could just go where I am now since its so close. Plus I love my infusion nurse & all the people there. But I do want a different oncologist. But I wasn't sure it could be done? Your post gives me some hope.

Chelee

kk1 · 12-14-2006, 07:57 AM

Hi Chellee;

yes it is possible. But usually for the infusion costs to be covered under your insurance the orders have to be written by a doc in your network. I was able to make this work by finding an in network doctor that was willing to work with a consulting onc. Basically the out of network doc would send instructions/orders to the in network doc who would submit them to the local hospital. I would also have to see the in network onc periodically. It was an interesting experience as sometimes the they had differeing opinions....the key is finding two good oncs that are willing to work together. I found the pair by going thru the provider directory and calling their offices and asking them if they would be willing to work in a cooperative way with the consulting onc. The Onc at UCLS may even know someone in your area.

KK1

chrisy · 12-15-2006, 10:52 PM

Hi Chelee,
Wow, that was weird - I just clicked out of the middle of my response!
I see a doctor in San Francisco and get my treatment from my local oncologist in Santa Cruz. It's a bit of a different situation, as both doctors are involved in the treatment decisions but I am technically being treated by the local doctor. It works well for me; the key being that they work well together.
Your situation is different, but I think the principal that you can be treated locally still is possible.
Good luck
Chris

Chelee · 12-16-2006, 12:16 AM

KKI, I think I will toss this idea at them and see what they say? If that type of arrangment could be made I would be thrilled. Its sounded more and more like this might be possible after hearing from all of you. The trick is to get the insurance company to ok it...and two oncologist to work together it sounds like. Thanks so much.

Chrisy, Since your doing something close to what KKI mentioned...I am curious if you both have PPO's or HMO's? Sometimes with a PPO you have alot more options. But at this point I think my cancer center wants me gone so I am not sure if they will let me arrange this or not, but I sure will find out? Now that I am armed with this information...time to call the HMO lady I have been dealing with & see what can be worked out regarding this type of arrangment. (I'm crossing my fingers & toes.) Thanks again to all of you!

Chelee

chrisy · 12-16-2006, 09:18 AM

Chelee,
Yes, I do have a PPO so it was a little easier, although I still had to deal with the in network/out of network issue. As I said, my arrangement works well because my local doctor is really into the idea of working with my consulting oncologist; AND I have a good relationship with both so it's not a problem for me to have continuing dialog with both. Also, it works for me (right now anyway!) to only see the consulting doctor every 3 months or so - I save up my questions for those visits. This relationship began as a 2nd opinion consultation at which I decided I wanted her directing the treatment. If you are not having any issues now that you are beyond your chemo treatments, an arrangement like this might work for you - although it sounds more like you are just not comfortable continuing to work with your local onc.
Maybe you can find another LOCAL onc who would be supportive of collaborating with the doctor in LA, then you could still get the benefit of the big guns without the headache of the drive.
Good luck!
Chris

Chelee · 12-16-2006, 11:27 PM

chrisy, I thought you might have a PPO.

Thats always a *good* thing. Makes life easier...more out of pocket...but well worth it if you can afford it. I would have no problems at all right now if I had a PPO...the only way to go.

Your current arrangment sounds ideal. Thats exactly what I would *like* to do. The sad part is I do like this entire place & all the people there. Its just the on-going problem I have with my onc. Her doctoring style does not work for me. I would STAY with her if she would just start talking to me. Its so simply...but she won't...and I've tried everything. She is very intelligent, but she is one of those that feels you should just listen and not ask questions I suppose? Everyone at this place is great. But she needs to take my questions and concerns seriously and she doesn't. She is in and out of the room on my appts in 6 minutes if I am lucky. The entire time is her writing orders. Never exams me. Then she leaves.

Right now I am not having any major issues...thats why I need to make changes now. My Mother unfortunetly was DX with stage IV lung cancer and is now going to the same cancer center as I am. She has one of the NEW onc that joined a while ago. She REALLY likes him. From what she has told me, he is a dream come true. So I want to switch over to him and see if maybe he couldn't work together with an oncologist I choose at UCLA? That way I could pretty much do what your doing...thats what I am shooting for. But we will see?

I hope something can be worked out soon. I do have a few issues that need to be addressed regarding my last results of the Dexa scan...& fluid in my chest, concerns I have with lymph nodes in my neck. Plus MRI of hips that has been requested now TWICE to me done on my hips yet she won't do it. I hope this lady from the HMO can work something out for me soon.

Thanks chrisy.

Chelee