The power of social media comes to the aid of an Oklahoma teen fighting her insurance company.
Lorelei Decker says Blue Cross Blue Shield said "No" to a procedure doctors say is her last hope to beat cancer. Decker launched a Twitter campaign and now her insurance company has changed its mind.
Decker's battle with Hodgkin lymphoma hasn't been an easy one. Six months of chemotherapy didn't work. Neither did a bone Marrow transplant.
"It's rough to say, but this is essentially my last option," Decker told News 9 on Wednesday.
Decker says doctors at MD Anderson in Houston want to transplant bone marrow stem cells from her sister. But BCBS told her procedure wasn't "medically necessary."
"They denied my application a day before [my sister] was supposed to leave for Houston," Decker said. "We were blindsided. I was terrified. My family was angry."
Decker captured the hearts of the city last year, with a Make-A-Wish stint as Oklahoma City Thunder Coach. She capitalized on that popularity by using Twitter to take on the insurance company. Within hours, the Twitterverse was abuzz with #ApproveLorelie.
"Blue Cross Blue Shield has basically put a value on my life. The money that it will cost to cover the transplant that I need is not worth my life," Decker said.
In a statement, Hilarie Houghton Sr. Supervisor of Public Relations for Blue Cross and Blue Shield of Oklahoma said:
"As a member-owned company, Blue Cross and Blue Shield of Oklahoma takes all member concerns seriously. We are committed to protecting our member's privacy and – following state and federal privacy laws – we are not permitted to disclose details of any individual member's health care without their authorization.
We have an established medical review process to ensure that our members receive appropriate, necessary and effective care. In general the process may include predetermination/preauthorization, an initial review policy determination by an internal medical doctor, a peer-to-peer review (a discussion between the member's doctor and a Blue Cross doctor to exchange pertinent information) and an appeals process that offers a clinical review by a specialty doctor, often a third party.
BCBSOK respects the roles of our members and their doctors in making treatment decisions; however, we must adhere to the plan certificates and regulatory guidelines that direct us regarding coverage decisions, determining what therapies are of proven efficacy, and evaluation of unusual therapies."
But in Lorelei's case, it seems to have reconsidered. On Wednesday afternoon Lorelei says Blue Cross and Blue Shield reversed its decision.
"It's not OK for Blue Cross to approve me now and then be applauded for what they always should have done," said Decker.
Lorelei's family canceled all their plane reservations and doctor's appointments and now has go through the difficult and expensive task of trying reschedule them again on short notice.
Doctors have told Lorelei that this treatment has about a 30% success rate.