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United Healthcare Optum Cancer Resource Center ?

3 years 8 months ago #48667 by rocksteady
I got a call/ voice mail from them also, stating it was important I speak with them. I called her back twice but she never returned my calls. Finally I got a letter from them stating pretty much the the same things in these posts.
I simply don't trust them. This is my second year with them and they haven't inserted themselves into any of my other problems, CAD, peripheral artery disease etc. I got the feeling reading their letter that they were looking for ways to deny claims, put me with other providers etc. My urologist is widely recommended in my area/ hospital as the best and iff I felt I needed a second opinion, change of provider, I wouldn't seek UHC's opinion as their primary goal is save/ make money.

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3 years 8 months ago #48577 by MadLove
Thanks, Cynthia, for sharing your experience. It's not obvious to me what value would be added to our situation. We have had great access to our doctor. It doesn't seem like it would be to our benefit to funnel or filter doctor-patient information through an agent who is not providing direct care. Thanks, again.

Husband's journey:
01/2015 1st cystoscopy
03&04/2015 TURBTs-CIS
07/2015 Finished BCGx6
08/2015 biopsy-BENIGN!
10/2015 Finished BCGx3
12/2015 Cysto, redness
01/2016 TURBT, Benign
04/2016 Cysto
05/2016 Finished BCGx3
07&11/2016 Cysto's
1/2017 Finished BCGx3
2/2017 Cysto, redness
3/2017 TURBT, Cysto...

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3 years 8 months ago #48576 by Cynthia
When I was DXed in 04 we had United Health and they contacted me. They had assigned a nurse coordinator who was very aggressive about offering her service. She wanted to make sure that I was getting appropriate care. I told her I was being cared for at one of the top places in the country but she kept asking a lot of questions and I could not understand her value added. I had concerns with talking about my health with someone who was writing down everything I said and it was before the health care privacy act, that may have been paranoia on my part but it worried me. I was a situation where she called often and I told her nothing. I finally told her I did not feel at ease talking to someone that was not part of my health care team about private matters and I did not wish her to call me again. Now looking back I still find the situation strange and intrusive. The bottom line is that it did not affect my coverage.

I sounds like they have changed the program and now you can chose to work with them. I think some people do need help when first DXed but others have it in hand. I am sure that the intent is to make sure money is not wasted on inappropriate treatment as well as to steer someone to appropriate treatment. I can't advise you on what to do but I thought I would share my experience even though I am sure things have changed since then.

Cynthia Kinsella
T2 g3 CIS 8/04
Clinical Trial
Chemotherapy & Radiation 10/04-12/04
Chemotherapy 3/05-5/05
BCG 9/05-1-06
RC w/umbilical Indiana pouch 5/06
Left Nephrectomy 1/09
President American Bladder Cancer Society

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3 years 8 months ago #48575 by Alan
Wow! John Hopkins is well respected on their bladder cancer. Strike any doubt I have might have fostered. Keep posting on any questions as someone will have "been there done that".

DX 5/6/2008 TAG3 papillary tumor .5 CM in size. 2 TURBS followed by 6 instillations of BCG weekly with a second round of 6 after a 6 week wait.
The following user(s) said Thank You: MadLove

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3 years 8 months ago #48573 by MadLove
Thanks, Alan. We are working with a uro-oncologist at Johns Hopkins after obtaining our 2nd opinion there. First TURBT 03-11-15, CIS, with second TURBT to be scheduled in a few weeks after my husband's bladder has recuperated. It was a substantial resection which can be significant with the CIS diagnosis.

We've been advised of potential treatment scenarios which will be finalized once the TURB #2 path report is available. The options reviewed are similar to what many forum contributors have shared about their treatment for high grade non-invasive BC.

Our confidence in the doctor is complete which has basically eliminated the overwhelming feeling of needing to be a 24/7 advocate with medical staff. We're rolling along and want to avoid any potential and unnecessary roadblocks due to insurance issues. To be sure, I've gotten second opinions of what is covered from the health insurance agents.

I'm on the same page about not inserting a third party nurse coordinator into the process. It seems to have the potential for countermanding the treatment plan our doctor will propose.

Thanks again for the comments.

Husband's journey:
01/2015 1st cystoscopy
03&04/2015 TURBTs-CIS
07/2015 Finished BCGx6
08/2015 biopsy-BENIGN!
10/2015 Finished BCGx3
12/2015 Cysto, redness
01/2016 TURBT, Benign
04/2016 Cysto
05/2016 Finished BCGx3
07&11/2016 Cysto's
1/2017 Finished BCGx3
2/2017 Cysto, redness
3/2017 TURBT, Cysto...

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3 years 8 months ago #48569 by Alan
I know little about United Healthcare as I am BCBS except that United is a major (big) insurer. Many of us on this site encourage active participation in your care. The important item is how good is your urologist? And, will he/she see 100+ cases a years as many will see mostly prostatic cases! This is a sneaky cancer that while manageable, it has a high re-occuremt rate. Also, many of us will encourage a second opinion as so many things are overlooked or flat missed the first time. Personally, I want to deal directly with my URO and not a nurse co-ordinator if possible.

DX 5/6/2008 TAG3 papillary tumor .5 CM in size. 2 TURBS followed by 6 instillations of BCG weekly with a second round of 6 after a 6 week wait.

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