I am an Oncologist specializing in Radiation treatments for cancer. Radiation saves lives. Tweets my own, RT not endorsement, #radonc
Joined January 2018
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Are peer reviewers the new telemarketers? I got 4 straight calls from a reviewer asking me to drop IGRT code on a Saturday afternoon. I missed the calls. Case denied! #radonc #fixpriorauth
Just had an ARNP call for a P2P and she introduced herself as “medical director”. She was unable to approve and had to escalate to a #radonc. Well, she was speaking to a RadOnc. #fixpriorauth #wasteoftime
Excellent commentary about PRIME II by FCS medical oncologists that helps put things in perspective. #radonc flcancer.com/articles/study-…
P2P with @UHC spoke with a nurse practitioner who was very kind but unable to make decision, had to check with rad onc, well, she was talking to a #radonc #wasteoftime #fixpriorauth
New low for prior auth @UHC #fixpriorauth worse part than the 3 am text is that it is for Supraclav/nodes IGRT approval
Luis Carrascosa retweeted
Press release on PSMAfore trial, a ph3 study of pts with mCRPC randomized to switch of androgen receptor pathway inhibitor or 177Lu-PSMA tx.
✅1° endpt of sig improvement in radiographic PFS met
✅ no unexpected safety findings
novartis.com/news/media-rele…
#radiopharmaceuticals
#radonc How soon do you do post XRT follow up?
9%2 weeks
79%4-8 weeks
9%91 days or later
4%I don’t see follow ups
82 votes • Final results#radonc @uhc and optum do not approve IGRT for right whole breast but they do for the boost, that makes no sense. WB is a bigger volume to a much higher dose 40 Gy vs 10 Gy therefore more need to be accurate daily during WB #fixpriorauth #80sradiation
Luis Carrascosa retweeted
Webinar will take place online on Nov 8.
Features ☢️insights and tips from
✅ Medical Physics/Rad safety
✅ Academic physicians
✅ Community physicians
Register here: americanbrachytherapy.org/me…
#radonc #radiopharmaceuticals #nucmed
This can’t be emphasized enough #radonc
Optum and @UHC denied IMRT for medically inoperable bladder cancer!! Peer reviewer not available. Appealed, they say reviewer has 8 more days to make decision #fixpriorauth #delayofcare
#radonc why 180=200cGy ie “standard fractionation” but 200≠220cGy because 220 would be “hypofractionation”. Peer reviewer denied IMRT x 28 for early endometrial like if I was not following nccn 45-50 Gy Rec #fixpriorauth
I just attended a tumor board and a surgeon recommended twice a day post mastectomy radiation based on a local radiation oncologists (ACR accredited) recommendation “to reduce complications”What?? #radonc #bcsm @RadiologyACR
Me in 1999: I wish I could do films every day before radiation to be sure we are doing it safely and precisely. Me in 2022: I wish the insurance co would allow me to do films every day before radiation to be sure we are doing it safely and precisely. #fixpriorauth #radonc
Another @evicorehc tale. P2P for IMRT for unresectable duodenal cancer denied by reviewer according to their “guidelines” needs 1980’s 3D conformal xrt. Problem is they don’t have guideline for duodenal. Reviewer extrapolated from pancreas indicated 3D!#fixpriorauth #radonc
So we submitted a 3D plan to @evicorehc for comparison, IMRT clearly superior. They reject the DVH comparison because it did not have the pt DOB on the DVH!! The patient has required hospitalization for GI bleed from tumor, outrageous!! #fixpriorauth #evilcore #radonc
Peer to peer with @UHC for SBRT oligomets. They are lazy, didn’t look at CT that showed progression of disease, oligometastatic. Reviewer spends few minutes in monologue trying to find excuse, he can’t, ends up approving. #fixpriorauth #wasteoftime #radonc
Recently I’ve been a little more vocal on twitter regarding insurance companies and utilization review groups #fixpriorauth. I have noticed an uptick in denials and peer to peer for standard of care treatments. Coincidence or not?? #radonc
Another huge waste of time, evilcore @evicorehc denied Pet scan because xrt finished less than 12 weeks ago, only problem is they didn’t pay attention and it ended over 1 year ago!! #fixpriorauth Treatment delayed. I had to step out of a consult for this nonsense!