“Why does it take so long?” That is the question Carl Larsen was asking himself. As a prostate cancer patient going through treatment, Carl knew he would face some challenges. He was expecting he might face side effects from his treatment including fatigue. As an endurance athlete preparing for another Chicago marathon, he was doing what he could to stay on top of his training and keep himself healthy – both physically and mentally. What he was not expecting was waiting and waiting and waiting.
Carl’s insurance company required him to get a referral from his primary physician before he could start his radiation therapy. A referral requirement is not all that unusual from insurance companies. Paperwork is at the heart of our health care system, with many patients carrying heavy binders filled with documentation from appointment to appointment. But what was unusual was how long he had to wait. As Carl said “Good thing I wasn’t dying.”
Unfortunately the nightmare of red tape continued for Carl. He was religiously checking his insurance online portal waiting for the green light that says he is approved to make the appointment with his radiologist. It took SIX months to process the referral. Finally Carl gets the approved message on the portal and he feels like he can breathe again. He wants to get his treatment started so he can put all this behind him.
Carl makes the appointment to start his treatment thinking he is in the clear. He is ready to soldier on to fight his prostate cancer with radiation treatment and his running regime. He comes to find out that the message in the portal only told him half the story, That’s right, the word approved was not enough. He actually needed to click on another box on the screen that said “get details” to take some additional steps to finally get approved. This is the perfect example of the many obstacles so many patients are facing that prevent them from getting the care they need. It is heartbreaking to think of the many patients who abandon their treatment because of these very circumstances.
Carl had spent hours on the phone trying to get his insurance coverage sorted out. Collection agencies were sending him notices. He felt frustrated, stressed, and even defeated. He was getting nowhere and finally he reached out on social media with a passionate plea for patients everywhere: It shouldn’t be so hard, there has to be a better way. Luckily for Carl, ZERO’s CEO was listening. Jamie saw Carl’s Facebook post and told him about ZERO360, a free program specifically for prostate cancer patients who are facing financial obstacles to getting their care.
Carl called ZERO360 and was assigned a case manager who helped him every step of the way with compassion and determination. His case manager initiated multiple calls with Carl’s insurance company, so that all three parties could walk through the details of what had happened and how it could be rectified. Carl felt such relief having an advocate in his corner who understood his unique situation and could take action to resolve it. With the case manager’s help, Carl’s insurance bills were taken care of. Hundreds of dollars he should have never been billed for were finally removed.
It was a long overdue sigh of relief for Carl and his family. Now Carl is making it his mission to make sure other men know about ZERO360 and that they are not alone. Carl also finished his sixth straight Chicago Marathon this October as one of ZERO endurance athletes raising funds and awareness for prostate cancer. He is a serial marathoner finishing ten marathons over the last five years. Coming up, Carl will be running the Indianapolis Monumental Half Marathon in 10 days and his 11th St Jude Marathon in Memphis on December 1 – all to raise funds as part of Team ZERO.
Thanks Carl for sharing your story and being an inspiration to us all!