Insurance "protocol"?

[kib]

Ok, so some of all that preliminary screening stuff did not come back so well. Sucks to be me today.

I realize I need to talk directly with my ins. co. but today is Sunday and I can't, and I'm also on my pre-colonoscopy liquid diet all day >8), so just antsy and anxious and gonna ask you guys while I sit here fussing.

I have three spots of bcc skin cancer that are going to be treated next week. The dermatologist's office says they have to be scheduled on three separate days because BCBS will only cover 1 procedure a day. Frankly, that sounds like BS to me, an awesome way of getting extra money. If it's truly necessary then ok, but this is a lot of extra anxiety, pain, time and probably expense for me.

The other thing that's making me anxious is that one of the spots is on my face. it looks tiny but bcc can sometimes be deceiving. I asked about reconstruction if necessary and got this not-particularly-professional answer: "Oh, most people aren't happy with the scarring, but Dr. X does cosmetic laser work too, so she can take care of that later on." How nice for her. I guess I'm anxious because I've read that the best results are - when it's necessary at all - to do skin graft surgery at the time the wound is initially open, before it's either half healed and inflamed, or scarred up. I feel like maybe I'm being pushed into a particular protocol because that's what this office specializes in, not necessarily because it's the best option.

I'd appreciate any feedback, you can PM me if you prefer. TIA.

[Teacher Terry]

My Mom had bouts of skin cancer & some was melanoma for 40 years. It was on her face & arms. Twice they did a chemical peel that she did at home & it left no scarring but was really painful. After that she elected to have it cut out. Her surgeon was so good that you could not see the scar. I am wishing you the best of luck:)) I would look into all of this because you don't want to be taken advantage of.

[rodeosweetheart]

I am so sorry to hear you are going through this! Is there a way to get a second opinion from a plastic surgeon about the one on your face? I took my son to a plastic surgeon when he injured his face, and although he healed up without needing any attention from the plastic surgeon, it was really comforting to get a second opinion!

Your insurance may have someone they can assign to your case to oversee coordination of treatment--maybe on Monday you could ask about this? Maybe someone here knows about this? When I was coming out of coma/off ventilator. paralyzed insurance assigned someone to manage my case and she actually called me--maybe you can request someone to help you like that?

[rosarugosa]

Sorry, Kib, and the colonoscopy prep is just icing on the cake :( I do have a co-worker who had some skin cancer spots removed surgically, several in one day, and we are also covered by BC/BS. The idea of the ins co demanding separate days doesn't sound logical to me. It does make me think the practice can bill more if they are done on separate days, so I would look into this carefully, since it doesn't sound like they necessarily have your best interests at heart.

[freshstart]

I agree, ask to be assigned a case manager at the insurance company, mine you get assigned a nurse, someone who would understand why doing them separately is just stupid and expensive and she would understand your concerns about scarring on your face. Maybe a second opinion is in order, especially for the one on your face. Your doc may be saying someone else can fix the scarring later, well, your insurance may not pay for something they deem cosmetic, whereas they have to pay for BCCs. So maybe you can get the one on your face at least done by someone trained and with the equipment to lower the chance for scars.

Good for you for managing these, so many people ignore them. My dad is very fair and worked shirtless on a farm for years every summer. He got a new primary who said, "Don, WTH, you have more skin with BCCs than without! Get to the dermatologist!" Other primary never said a word. So for the past few years, he's gone every few months and they take off more each time, I stopped listening at like "78 so far!" because I am amazed that he never got melanoma. For some reason, I cannot recall what procedure they are using to get them off just now, I will check because whatever they are using is leaving very little scarring. It's impressive.

good luck with the colonoscopy! You're having a banner week, sheesh.

[kib]

They're doing Mohs surgery on 2, which supposedly leaves the least scarring because it leaves the most healthy tissue. It can be time consuming and I do understand why they might want to schedule more than one appointment just in case, but "because the insurance company insists" still sounds like nonsense to me. I will see what the ins. co has to say about that, a coordinator, and about a plastic surgeon co-procedure.

Thank you to everyone for the support and advice. The colo is just a standard screening (I hope, fingers crossed I'm not as spotted on the inside as the outside.)