In the time from my last reply to now….I too learned there will be no more “on the fly” peer-to-peers. It is a scheduled call.

One more thing…I have learned from speaking to many physician reviewers, the majority of the time, they are not oncologists! Often they are internists, or other specialty MDs, that just sit with guidelines in front of them- and that is how decisions are made. I understand the rationale by ensuring tests are indeed medically necessary and to be economically prudent, but as we all know….melanoma does not like to play by the rules, and often certain situations require certain specialty radiologic imaging. Decisions made by non-oncology physician providers are not always in the best interest of the patients (at least this is my experience…at times, now always).