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Wednesday, February 24, 2010

Rallying the Troops

***Update***
There is linkto file an online complaint form with Scott and White Health Plan and then you can follow up with a call in the morning, print it and mail it.

There will be a meeting at 8:00 in the morning for a ruling on my case. This will among with MDA staff to see if they are willing to work with my crazy insurance to cover my surgery. Our awesome state representative, Fred Brown, is providing tons of support, encouragement and guidance! We will go to MD Anderson and await word on their ruling on whether or not I will be allowed to proceed tomorrow or will be forced to wait on a later surgery date. Your prayers are desperately needed.

Hi everyone! We are here at MD Anderson in Houston. Day one of testing is complete but we are once more at a roadblock. Scott & White Health Plan has denied in-contract, in-network coverage for tomorrow’s testing and Friday’s surgery. We are moving as fast and furious as we can trying to get some cost estimates for our out-of-pocket expenses if we are to proceed with the treatment scheduled for tomorrow and Friday. We strongly feel S&WHP should cover this as in-contract, in-network due to the fact one of the primary factors in a patient’s best chance at surviving sarcoma of the breast is treatment in a qualified sarcoma center. MD Anderson is one of the very best sarcoma centers in the world. Scott & White Temple, St. Joseph’s Hospital in Bryan and Baylor Dallas, while all wonderful medical institutions are NOT qualified sarcoma centers. Below is a copy of my sister-in-law’s post on our call to action. Thanks for all the love, support and prayers you have been giving us. It means so much!

- Andrew & Lisa Smith and family, College Station, TX

-----

CALL TO ACTION

In grappling for a concrete way to HELP Lisa in her battle to: 1. get testing and surgery tomorrow and Friday, 2. get a complete diagnosis and treatment plan, and 3. beat cancer once and for all, we've discussed a lot of different ideas.

As you probably already know, there is the care calendar where you can logon (Calendar ID: 31452 Security Code: 9389) and sign up to help by bringing dinner, cleaning the house, etc). It's a great way to help, especially if you're in College Station. For those of us who are not, it's a little more challenging to be effective and helpful in that way.

There's also a donation PO Box that has been set up. For those of us who feel called to support the Smiths monetarily, that's a great (and *very* helpful) way to help.

There is a (now completely full!!!) prayer wall dedicated to Lisa and the family. This is a great option for everyone to take a few minutes out of your day and ask God to please watch over Lisa and her family during this time.

And now, we've got another way you can help. This is an important action-oriented call for help. We need phone calls AND we need letters!

Matt (my husband) did a test run this morning and was able to speak with a very kind woman at Scott and White Health Plan (Lisa's insurance carrier) about our concerns for Lisa's health and treatment and our desire to have S&WHP cover Lisa to be seen and treated at MD Anderson. He included a few facts and a quick summary and she was happy to take down his concerns and pass them on to be included (as a tally) in Lisa's file.

She was also very open in sharing with him the best and most effective way to make sure that S&WHP knows how many of us are on her side and how many of us are united in our fight to get Lisa treated at MDA. She passed along some important information in our struggle to be effective:

Every letter that is sent to S&WHP on Lisa's behalf is attached to her file.

Every.single.letter.

Every call is logged and tallied and attached to her file.

Every.single.call.

She offered that letters can certainly *look* more impressive than calls as the calls are merely tallied whereas the letters are actually attached. Can you imagine 200, 400, 800 letters included in her file when S&WHP reviews her case?! AND 200, 400, 800 CALLS tallied to express the public's support and concern that Lisa be given the best chance of beating this disease?!

I think it would be awesome to have all of our letters and phone calls there representing each of us who are supporting and working for Lisa when the board reviews her appeal. ANYONE can write a letter. ANYONE can help Lisa win entrance as an "in-network" patient for lymphoscintigraphy testing (or nuclear lymph node mapping) tomorrow and a segmental mastectomy on Friday at MDA.

I'm asking that you take a few minutes to sit down and write (or type) a letter to S&WHP expressing your concern for Lisa's health and treatment and your desire to have them allow her to receive these two procedures as an "in-network" patient at MDA.

One example or what you may want to express to S&WHP is this:

Lisa Meador Smith of College Station, TX (d.o.b. 11/18/70) needs for S&WHP to extend her coverage to include lymphoscintigraphy testing (or nuclear lymph node mapping) tomorrow and a segmental mastectomy on Friday at MD Anderson.

MD Anderson is the leading research institution specializing in her extremely rare form of cancer. The highly aggressive, soft tissue sarcoma of the breast that Lisa is combating can be treated with the highest probability of success at a specialized sarcoma research institution where they treat soft tissue sarcoma of the breast patients on a daily basis. Fortunately, MD Anderson is recognized as the world's leading institution in this type of cancer and it's right here in Texas.

Thank you so much for your attention and compassion. And thank you in advance for making the decision to help save Lisa's life.

Please make the decision to approve Lisa's coverage for treatment at MD Anderson. It's the right thing to do.

Another way to express your concern may be:

Lisa Smith of College Station, TX (d.o.b. 11/18/70) has an extremely rare type of cancer: Soft Tissue Sarcoma of the breast. Her doctor isn't able to give her a complete diagnosis. Soft Tissue Sarcoma must be treated by a Sarcoma Specialist who sees multiple sarcoma patients regularly. Scott and White recommended an immediate mastectomy surgery but, MD Anderson soft-tissue sarcoma specialist, Dr. Jonathan Trent has said more data is required before making a decision of this caliber.

And, according to research at the University of Miami School of Medicine, there is a significantly higher success rates for patients treated at major sarcoma centers.

Soft Tissue Sarcomas are rare. This leaves most health care institutions with outdated or inadequate resources, which impede the ability to offer optimal treatment of these rare and often complicated tumors.

An article from the UCLA School of Medicine, "Surgical Management of Soft Tissue Tumors: Avoiding the Pitfalls," notes the best way to avoid surgical errors for rare tumors (and, remember, all sarcomas are rare) is to be treated at a specialty center with an experienced multidisciplinary team.

Scott and White does not and cannot offer such a specialty center.

MD Anderson has the best sarcoma treatment center in the world. They are willing and able to help save Lisa's life.

Please approve Lisa's request to be seen as an "in-network" patient for lymphoscintigraphy testing (or nuclear lymph node mapping) tomorrow and a segmental mastectomy on Friday at MD Anderson so she can receive the treatment that she needs to beat this cancer.

Finally, you may want to say something like this in your call and letter to S&WHP:

My concern is that Lisa Smith (d.o.b. 11/18/70) of College Station, Texas, has been diagnosed with an exceedingly rare type of cancer: Soft Tissue Sarcoma of the breast.

Seeing the right type of specialist is the NUMBER ONE factor supporting patient survival without recurring cancer and, unfortunately, sarcoma is highly recurring.

Scott and White doctors, while wonderful, are not equipped to fully diagnose and treat Lisa. Their inability to do so is threatening her life.

Please allow her to be seen at MD Anderson.

Please approve her to be seen at MD Anderson as an "in-network" patient for lymphoscintigraphy testing (or nuclear lymph node mapping) tomorrow and a segmental mastectomy on Friday.

These three samples are just guides to help you formulate your communications with S&WHP.

Please, please, please CALL AND SEND A LETTER today!

Gather your family and friends and have each person send their own letter and make their own call.

Numbers matter.

Please help us!

Scott and White Health Plan Phone Number: 1-800-321-7947

*update*

When you call they will ask you for your name and a daytime telephone number. They will also ask for your relationship to Lisa. Everyone is allowed to call and voice their concern whether it is a friend, family member or concerned citizen. They may tell you that they cannot release any info about Lisa. That's great -- we don't want them to release info we just want them to include our concerns in her file. Please be sure to include her full name and date of birth (11.18.70).

Thanks again!

Scott and White Health Plan Address

(please address the envelope exactly as it is below):

Scott and White Health Plan

ATTN: COMPLAINTS

2401 South 31st Street

Temple, TX 76508

*update*

Apparently, you can also FAX letters to S&WHP: 1.254.298.3385 (thanks to Lori Enzor for that information!!)

FINALLY, when you've made your phone call and when you've sent your letter please post here to let us know!!

I feel so fortunate to have so many people on board to support my sister-in-law in this battle for her health.

Thank you in advance.

And Please Pass the Word!

Ok, guys, please leave me a comment telling me about all the phone calls and faxes you are making, please follow this up with a letter but we need an answer by tomorrow...so please, please, please take a second and make the call and send the fax. We love you all!

46 comments:

ASHLEY said...

fax sent this afternoon around 3:15

The Mitchells said...

faxing as I type at 3:36pm!

Anonymous said...

Just sent my fax 4:45 Eastern time. Sandy Bowman

Andrea said...

This denial pushes me OVER THE TOP. I am not a happy camper as I am sure most of you aren't either. Ridiculous is the most pleasant word I can muster right now.

Storming the heavens with you,
andrea

Darlene Fairchild said...

Fax went through at 3:37 pm and we are rallying the troups here in the office to fax and/or call them. You are in our prayers

His Girl said...

faxed! 1:58 PST.

will continue to pray.

(picturing Jesus storming in like a Daddy defending His bullied child POW!)

Anonymous said...

My call to SWHP has been logged. Now I'm calling to The Higher power.

Love,
Kim Koenig

Becca said...

Faxed and just called 4:15, praying constantly

Bernie said...

Will a letter be accepted from Canada? Am praying so hard for Lisa and her family....:-) Hugs

PLEASE EVERYONE MAKE YOUR PHONE CALLS AND FAX YOUR LETTERS FOR OUR LISA.....

Anonymous said...

Here's a link to an online form you can submit if you don't have access to a fax.

https://www1.sw.org/web/patientsAndVisitors/iwcontent/public/common/forms/Secure/en_us/html/PatientRelationsReplyForm.html

Karen Rabroker

Joy Christine said...

I have made a call and bothh our faxes is on the way. I have one suggestion. you need to have more than letter per family to go out. Not just one per family. make sure that both husband and wife and any other adults in the house send letters with their names on it as well. This will give more paper work. This should also be done with the phone calls. That way they are overwhelmed. Joy @ joyfullyrefined.blogspot.com

Nancy said...

Called at 4:48 CST and will fax a letter now.

Jenn said...
This comment has been removed by the author.
Jenn said...

Made my call @ 4:45. Thanks for Karen for the online submission form for those of us w/out faxes. PRAYING! Love ya Lisa.

Jenn said...

Here is the full address to file a complaint online. Sent mine @ 5:00pm.


https://www1.sw.org/web/patientsAndVisitors/iwcontent/public/common/forms/Secure/en_us/html/PatientRelationsReplyForm.html

Melanie said...

Can I send the information online?

Denise said...

Done.

Anonymous said...

Submitted my concern using the online form at 5:30pm CT

https://www1.sw.org/web/patientsAndVisitors/iwcontent/public/common/forms/Secure/en_us/html/PatientRelationsReplyForm.html

sonja said...

Letter is ready to go, on my way right now to mail it!

Let's DO this thing!!!

HUGS LISA!!

Sonja

sonja said...

Lisa:

I've taken my letter to the PO drop slot, and I've also sent in an online form, signed by my husband to S&WHP just now, 6:15pm.

Sonja

Joy Christine said...

I have sent out an email to our friends as well. I have had one response come back that they sent a letter. We sent 3 email concerns as well through the link that Lisa left on the update. One for each of us in the house that are concerned with this situation. May God guide the meeting in the morning.Godspeed to all involved. Praying for a miracle!!!

Manuela said...

Send an online submission at 6:30 p.m.

Renee Swope said...

Just completed an online form with my letter.

Renee Swope said...

Sent a second online concern form with my husband's name. We're rallying for you and with you!!!!!

Melanie said...

I just filled out the online form and posted your information on my blog (I hope that is ok!) in hopes that my readers will also send in letters and PRAY for you.

... praying without ceasing...

Lots of love to you!

Libby said...

I submitted an online form!

Kirsten said...

sending a letter!

Amy Seay said...

I sent my fax. I love you Lisa and I am praying for complete healing for you every day!

The Taormina Family said...

Please take this to the media if you have not already! You have research backing up why she needs a highly specialized medical center. Having news stations, news papers, radio stations bring attention to her needs and showcasing the insurance company who is denying her can often have an impact as the insurance company will not want bad press!!! You are in my prayers!

Anonymous said...

Filled out the online form. Tomorrow will fax as well. Miriam Gerdes

The Taormina Family said...

Please take this to the media if you have not already! You have research to back up why Lisa needs a specialized medical center....information that the media can use. News stations, news papers, radio stations showcasing Lisa's needs and the insurance company's denial can often be effective as the insurance companies don't want bad press! You are in my thoughts and prayers!

charity farnsworth said...

Lisa and Andrew...I hope it isn't too late for this, but I just found the post about your request. I used the online form to send in a letter too. Keeping you in my thoughts and prayers.....

His Hers Ours and Autism said...

Done. 10:24 p.m.

Gigi said...

I have submitted the electronic "complaint" form and will be following up in the morning with a faxed letter.

Deep breaths everyone...

All to His glory! He is STILL on the throne!

Holly Moore said...

I, too, just found the request and sent a letter through the online link. We are praying for you and your family!

Derek & Holly Moore

Terri Ratcliffe said...

Lisa, just wanted to let you know that Matt and I called and left a complaint on the PR line. We are both continuing to pray as well.
We love you guys!
Matt and Terri Ratcliffe

Meleah said...

Just Faxed 2 letters. We will call tomorrow morning. I sent out an email to everyone on my email list. Posted on my FB page. I'll text friends tomorrow and send the number to call at Scott and White. If you know what time they are meeting to decide can I get a group together to pray, picket the office, anything else? We love you Lisa! I know God is sustaining you!

Anonymous said...

faxed mine and my mothers letter this morning at 8:00....Praying on your behalf. Loretta Beam

Anonymous said...

Filled the online form out and have also faxed a copy of my letter in. Lisa is a precious soul and deserves nothing but the best. God Bless and much love.

Julie said...

Submitted only form this morning at 10:30.

Praying like crazy that they do the right thing!

5Lips said...

Just filled out the online form (2/25/2010). Praying for you, Lisa!

Josie said...

fax sent earlier this morning

LeNeveu Family said...

I sent a letter online, and will be faxing a letter as well !

Makeup said...

just made a call at 3:23...talked Jennifer

Makeup said...

just made a call and spoke with Jennifer

Anonymous said...

Sent in an email.