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Patient Empowerment: How to Fight the Insurance Company and Win!

PROGRAM DETAILS:

Each year, some patients find themselves fighting the health insurance company just to stay alive. This may sound ludicrous, but it's a reality someone you know will face. While some have found it difficult for their voices to be heard over the health insurance giants, one patient, would not take no for an answer. On this episode of Patient Power, Dr. Darryl Zuckerman and his patient, Chuck Warman share an incredible story of patient empowerment.

Chuck Warman, a 50-year old applications engineer, was diagnosed with primary, inoperable liver cancer. Chuck spent a great deal of time educating himself about his condition, including researching all available treatments, even though he was only given 3-4 months to live. He and Dr. Zuckerman settled on a particular course of therapy based on Chuck’s research and he received two successful treatments. After the two initial treatments, his insurance company suddenly declared that additional treatments were medically unnecessary and refused to cover the cost. Rather than accepting their denial, Chuck decided to fight for coverage. He and his family battled it out with their carriers and, in the end, won back the coverage he needed. Having figured out how to work the system by educating himself, he helps to educate others through blogs and online forums, but also insists all this may have not been possible without his doctor.

Dr. Zuckerman is an experienced radiologist and Associate Professor of Radiology at the University of Cincinnati Medical Center. Dr. Zuckerman proved to be an invaluable resource to Chuck by assisting him with his efforts to educate himself about his condition, the treatments available, and which of those treatments would likely have the best chance of success. Dr. Zuckerman also helped Chuck during his struggle with his insurance carrier over reimbursement policies for his Therasphere® treatments by meeting with company representatives to discuss why the treatments were indeed necessary to save Chuck's life. Finally, Dr. Zuckerman took an interested and active personal role in treating Chuck's illness. His efforts to take a personal role in Chuck's treatments alleviated the fear and helplessness that patients often feel in an impersonal hospital or clinical setting. Listen to this program to hear more about how Chuck Warman fought the insurance company and won - if you experienced something similar or are searching for information on the topic, this program is a perfect place to start.

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EXPERTS & GUESTS:
Darryl Adam Zuckerman, M.D.
Radiologist, University of Cincinnati Medical Center
Dr. Zuckerman is an experienced radiologist and Associate Professor of Radiology at the University of Cincinnati Medical Center. Dr. Zuckerman received his medical degree from the State University of New York at Syracuse, completed residencies in internal medicine and radiology at Long Island Jewish Medical Center, and completed his fellowship in vascular radiology at the Massachusetts General Hospital. more >

Chuck Warman,
Patient Advocate, Fought the Insurance Company and Won
Mr. Warman helped to found a support group after his insurance company denied him coverage after only a couple treatments for his liver cancer. Having figured out how to work the system by educating himself, he helps to educate others through blogs and online forums. more >

TRANSCRIPT:

  1. Introduction
  2. A Doctor’s Perspective
  3. Patient Advocacy Resources and Strategies
  4. Getting Coverage for Cutting Edge Treatments

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