I have been a patient at the WMC Infusion Center for 2 years for infusions every eight weeks to treat my medical condition. The pre-authorization for this costly infusion was previously submitted by the facility where my prescribing physician was affiliated (two hours away). A month after I requested renewal of the pre-authorization, which expired this year, the facility informed me that they would no longer do pre-authorizations for infusions that were not done at their facility.
After several requests, including speaking with their hospital liaison and department chair, to submit the pre-authorization this one last time since we were so close to the infusion date they would not “budge” in their policy and refused to do this. I turned to Julia Rose, RN at the WMC Infusion Center about my problem. I was upset and frustrated and very concerned about the interruption in my treatment after finally getting my condition stabilized with the current treatment plan. In my mind my only alternative was to take a day off from work and travel two hours to have the infusion in order to have it pre-authorized. Not only was this a significant burden for me and my family (as I needed to be accompanied home after the infusion), but also a significant financial cost, as I am covered by Innovation Health (Valley Health sponsored healthcare insurance), which if a service is done by a “domestic” provider a high percentage of the infusion is covered resulting in significantly less out-of-pocket expense (the infusion is very expensive).
Julia listened and quickly went into action to see how she could help me. Although the infusion center had never done pre-authorizations, she was very willing to learn the process and seek out the assistance she needed. She scheduled a meeting the next day with someone to help with the process. By the following day she completed and submitted the pre-authorization request to my insurance company and also requested that approval be expedited.
I am very thankful to Julia for understanding my situation and being proactive in helping me to continue to have my infusions at WMC. Although having infusions every eight weeks in not something I look forward to, the staff at the WMC Infusion Center actually make this a pleasant experience for me with their excellent care and kindness. Not only was Julia concerned about me as a patient but she was also concerned that I was a client of the facility and did not want me to have to go elsewhere for infusion services. Julia went above and beyond to help me receive the care I needed and for this I am so appreciative!