Randy Montgomery Medical Fund
Donation protected
My name is Diane Brumbelow. I am the creator of this Go Fund Me page. As many of you may know, Randy was diagnosed with cancer in his tonsil and some lymph nodes back in November 2017 and soon after, he proceeded with 33 difficult proton treatments in the hopes of hearing at the end, the words “cancer free”. Time was of the essence, so they started immediately as they filed with insurance. However, BCBS denied the treatment even after being recommended by his doctor and continued to deny to pay after many appeals. Eventually, they paid 27 of the 33 treatments but continued to deny the last 6. But in July, those 27 payments came back to them as a payment error and BCBS has insisted on being refunded, and it is EXPENSIVE! My heart broke as I saw Tammye share this heartbreaking news on her Facebook page. As if they were not dealing with enough, why would they have to deal with this financial burden too? I had to do something. God led me to start this Go Fund Me page. They need our help financially so that they can concentrate on what important....Randy’s health. I am asking for three important things from you as his friends and family...One, PRAYER for complete healing and restore of strength for Randy. Two, GIVE here as you feel led to for his medical and travel expenses. And three, SHARE this with as many as you can through Facebook, email, texts, prayer lists, etc. Get the word out on this need for their family. Thank you all and God bless.
If you are not fully aware with Randy’s journey, here it is...
“At first, I thought I had strep throat, but when antibiotics failed to subdue a lump in my neck, my doctor called for a biopsy. The next several weeks were a whirlwind of tests, results, consultations, and research. I had HPV oropharyngeal cancer.
A CT scan revealed my cancer had originated in my right tonsil and affected three lymph nodes. I was told by experts that surgery would not be the best first option. Radiotherapy was prescribed, which would be enough to destroy my cancer, but would also expose surrounding healthy tissues and organs to radiation with lifelong side effects. My dentist then informed me about Proton therapy.
I was told I was a perfect candidate for Proton therapy by an expert physician and medical team at one of our nation’s leading cancer centers. I was warned that my insurer, Blue Cross Blue Shield, would likely deny payment, but that they had a whole team of people who would work on appeals on my behalf.
As predicted, a denial came from my insurer. We fought through one, two, three rounds of appeals. After the second appeal, we were told that if we planned to appeal a third time, that it would be denied, indicating an unwillingness to even consider the individual facts of my case, and just rubber-stamping the denial. Despite my appeals being marked urgent, requiring a 72-hour response, BCBS ignored the deadline on at least two occasions, according to my care team. When an independent review panel also denied Proton treatment, I felt defeated. My only options were to select traditional radiation therapy or find a way to cover my Proton therapy treatment out-of-pocket. The denial process also delayed treatment by weeks.
Running out of time and options, we sent a down payment to the provider so I could start Proton therapy while continuing to fight for coverage. I also turned to my State Representative who submitted a “legislative inquiry” to the Texas Department of Insurance to ask about the questionable response times on the denials.
A few weeks after submitting the inquiry, I was informed that the Enforcement Division of the Texas Department of Insurance was getting involved. Shortly thereafter, it appeared that payments may be coming in from my insurer.
After paying for 27 out of 33 of the treatments, they have now contacted us and MD Anderson stating that the 27 were paid in error and are demanding that MD Anderson return the funds.
My treatment was really tough, and I have had multiple professionals on my care team indicate that my complications and side effects would have been much worse had I been forced to receive conventional radiation.
I am incredibly fortunate and grateful that a treatment was available for my condition that offered fewer side effects and complications PLUS a successful outcome, but you should not have to spend your entire life-savings to get the treatment that you and your doctor agree on - having health insurance should be enough.” Randy Montgomery
If you are not fully aware with Randy’s journey, here it is...
“At first, I thought I had strep throat, but when antibiotics failed to subdue a lump in my neck, my doctor called for a biopsy. The next several weeks were a whirlwind of tests, results, consultations, and research. I had HPV oropharyngeal cancer.
A CT scan revealed my cancer had originated in my right tonsil and affected three lymph nodes. I was told by experts that surgery would not be the best first option. Radiotherapy was prescribed, which would be enough to destroy my cancer, but would also expose surrounding healthy tissues and organs to radiation with lifelong side effects. My dentist then informed me about Proton therapy.
I was told I was a perfect candidate for Proton therapy by an expert physician and medical team at one of our nation’s leading cancer centers. I was warned that my insurer, Blue Cross Blue Shield, would likely deny payment, but that they had a whole team of people who would work on appeals on my behalf.
As predicted, a denial came from my insurer. We fought through one, two, three rounds of appeals. After the second appeal, we were told that if we planned to appeal a third time, that it would be denied, indicating an unwillingness to even consider the individual facts of my case, and just rubber-stamping the denial. Despite my appeals being marked urgent, requiring a 72-hour response, BCBS ignored the deadline on at least two occasions, according to my care team. When an independent review panel also denied Proton treatment, I felt defeated. My only options were to select traditional radiation therapy or find a way to cover my Proton therapy treatment out-of-pocket. The denial process also delayed treatment by weeks.
Running out of time and options, we sent a down payment to the provider so I could start Proton therapy while continuing to fight for coverage. I also turned to my State Representative who submitted a “legislative inquiry” to the Texas Department of Insurance to ask about the questionable response times on the denials.
A few weeks after submitting the inquiry, I was informed that the Enforcement Division of the Texas Department of Insurance was getting involved. Shortly thereafter, it appeared that payments may be coming in from my insurer.
After paying for 27 out of 33 of the treatments, they have now contacted us and MD Anderson stating that the 27 were paid in error and are demanding that MD Anderson return the funds.
My treatment was really tough, and I have had multiple professionals on my care team indicate that my complications and side effects would have been much worse had I been forced to receive conventional radiation.
I am incredibly fortunate and grateful that a treatment was available for my condition that offered fewer side effects and complications PLUS a successful outcome, but you should not have to spend your entire life-savings to get the treatment that you and your doctor agree on - having health insurance should be enough.” Randy Montgomery
Organizer and beneficiary
Diane Brumbelow
Organizer
Wichita Falls, TX
Perry Montgomery
Beneficiary
