Post by admin on Jul 28, 2007 19:38:00 GMT -5
Passed away: July 27, 2007
Marlena Phelps Hodges
Marlena -Caringbridge Journal
Marlena Hodges DSRCT = Personal website.
Marlena Hodges = DSRCT timeline page. Lynchburg, Virginia
'This should not happen'
Teacher winning fight
Marlena Phelps Hodges
Marlena Phelps Hodges, 27, of Madison Heights, passed away Friday, July 27, 2007, with her family beside her.
She is survived by her devoted husband, Jeffrey W. Hodges; her parents, Delmus and Veronica Schiefler Phelps; father and mother-in-law, Thomas and Dianne Hodges; brothers and sisters, Daniel Phelps, Alexander Phelps, Benjamin Phelps, Stefan Phelps, Eleni Phelps and Kieran Phelps.
Also survived by her paternal grandparents, Delmus and Edeltraut Phelps; maternal grandmother, Renate Schiefler; paternal grandmother-in-law, Betsy Hodges; maternal grandparents-in-law, Jessie Vanaman and Doris Vanaman; and was preceded in death by her grandfather, Harry Schiefler; grandfather-in-law, John W. Hodges; and a cousin, Marcia Phelps.
Marlena was born in Langen, Germany on July 19, 1980. She graduated Radford University with a degree in education and was teaching at Perrymont Elementary School. She was a member of Timberlake U.M.C.; loved working with children, traveling, golfing, horseback riding and was involved with Bedford Orchestra.
A celebration of Marlena's life will be held at 3 p.m., Tuesday, July 31, 2007, at Timberlake United Methodist Church by the Rev. Larry C. Davies, with a reception to follow at the church.
In lieu of flowers, please consider Timberlake U.M.C. Parrish Nurses, 21649 Timberlake Road, Lynchburg, VA 24502; Duke Pediatric Bone Marrow Transplantation, Duke Comprehensive Cancer Center, DUMC P.O. Box 3350, Durham, NC 27710.
To learn more about Marlena and to keep up with her story, please go to www.caringbridge.org
Heritage Funeral Service and Crematory, 427 Graves Mill Road, (434) 239-2405 is assisting the family.
Condolences may be sent to the family at www.heritagefuneralandcremation.com.
She is survived by her devoted husband, Jeffrey W. Hodges; her parents, Delmus and Veronica Schiefler Phelps; father and mother-in-law, Thomas and Dianne Hodges; brothers and sisters, Daniel Phelps, Alexander Phelps, Benjamin Phelps, Stefan Phelps, Eleni Phelps and Kieran Phelps.
Also survived by her paternal grandparents, Delmus and Edeltraut Phelps; maternal grandmother, Renate Schiefler; paternal grandmother-in-law, Betsy Hodges; maternal grandparents-in-law, Jessie Vanaman and Doris Vanaman; and was preceded in death by her grandfather, Harry Schiefler; grandfather-in-law, John W. Hodges; and a cousin, Marcia Phelps.
Marlena was born in Langen, Germany on July 19, 1980. She graduated Radford University with a degree in education and was teaching at Perrymont Elementary School. She was a member of Timberlake U.M.C.; loved working with children, traveling, golfing, horseback riding and was involved with Bedford Orchestra.
A celebration of Marlena's life will be held at 3 p.m., Tuesday, July 31, 2007, at Timberlake United Methodist Church by the Rev. Larry C. Davies, with a reception to follow at the church.
In lieu of flowers, please consider Timberlake U.M.C. Parrish Nurses, 21649 Timberlake Road, Lynchburg, VA 24502; Duke Pediatric Bone Marrow Transplantation, Duke Comprehensive Cancer Center, DUMC P.O. Box 3350, Durham, NC 27710.
To learn more about Marlena and to keep up with her story, please go to www.caringbridge.org
Heritage Funeral Service and Crematory, 427 Graves Mill Road, (434) 239-2405 is assisting the family.
Condolences may be sent to the family at www.heritagefuneralandcremation.com.
Marlena -Caringbridge Journal
Marlena Hodges DSRCT = Personal website.
Marlena Hodges = DSRCT timeline page. Lynchburg, Virginia
'This should not happen'
'This should not happen'
Cynthia T. Pegram
cpegram@newsadvance.com
February 27, 2005
Barely into the new year, Marlena Hodges got the diagnosis no one wants to hear - rare, aggressive cancer.
At age 24 and a fifth-grade teacher at Perrymont Elementary School, she had not yet reached her second wedding anniversary with her husband Jeff.
A routine January visit to the doctor led to a cascade of referrals to specialists then a diagnosis of ovarian cancer - soon changed to an even rarer disease in young women, desmoplastic small round-cell tumor.
“It’s so rare, that it’s hard to find anybody who treats it,” said Jeff Hodges.
But they were able to.
Within five weeks, Marlena Hodges was admitted to a Washington hospital for surgery that doctors felt gave her the best chance.
And there was some comfort in having insurance through Lynchburg City Schools and access to the skills of a nationally known surgeon, Dr. Paul Sugarbaker, who specializes in treating the rare cancer.
Their hopes were focused on the surgery set for Feb. 8.
Then came crushing news on the eve of the surgery: It wasn’t going to happen.
The last-minute turndown stunned loved ones gathered in Washington and was especially brutal for Marlena, already fragile from the fast-growing cancer.
A battle by her family with the insurers followed, one that ultimately won approval for the surgery. She remains hospitalized and is undergoing chemotherapy.
Their fight sheds light on the rough edges where insurance plans meet high-cost health care.
Tom Hodges, an insurance agent and broker for life and health insurance, is Jeff Hodges’ father. He used every resource and contact he could think of to get the surgery back on track.
“I shouldn’t have had to have done everything I know to push the system,” said Hodges. “I shouldn’t have had to call my lawyer to get the right she was guaranteed when she paid her premiums.”
And so far, no one can say why the young woman was put through turmoil at the 11th hour because of negotiations between the three main players in determining coverage: Lynchburg’s Piedmont Community Health Plan (PCHP), which is the benefits administrator for the Lynchburg City School’s self-insured health plan; Miami-based Cairnstone, which represents the policy’s reinsurer on high-cost medical cases; and the Washington Hospital Center, where the surgery was performed.
But all agree patients shouldn’t have to go through a last-minute delay.
“This should not happen,” said Eric Wagner, senior vice president of managed care for the not-for-profit MedStar Health, which owns Washington Hospital Center.
“I can’t tell you for sure what actually occurred,” said Cheryl Midkiff, a spokesman for PCHP, a managed healthcare organization owned by Centra Health and 250 Lynchburg-area physicians.
“From this end, we approved it. And authorized it. And from our understanding it was going to happen.’’
And Jim Keller, Cairnstone vice president of operations, also said his company did not know how the denial was made.
“We’re in the background as reinsurers, not making those decisions,” he said.
“I’m not sure who cancelled it. It wouldn’t have been us. It wouldn’t have been PCHP, they’d already approved it.”
The Hodges thought everything was on track until Feb. 7, the day before the surgery was scheduled.
Tom and his wife Dianne went over to the surgeon’s office to pick up instructions and prescriptions for their daughter-in-law, who was expecting to be admitted to surgery early the next morning.
“It was quarter to five, and we walked in and they told us to sit down, they were having problems with negotiations with PCHP,” said Dianne Hodges.
Soon the Hodges were joined by Jeff and Marlena. A member of the surgeon’s office staff “came out and said, ‘they have turned you down,’” Dianne Hodges recalled.
The news was shattering for Marlena.
Both Hodges and Delmus Phelps, Marlena’s father, called Dr. David Smith, PCHP medical director.
“We were really scared,” said Phelps. “And I was shocked that they would cancel that late.”
He called people he thought would know people who could help. Local legislators were contacted.
Phelps contacted a lawyer, who said to let them know if nothing had changed by 7:30 a.m. the next day. The next morning, said Hodges, that call was made.
About 8 a.m., Jeff and Tom Hodges went to the hospital’s administrative offices and talked to the hospital president, James Caldas.
He assigned a patient advocate to them, Tom Hodges said, and told them she would do whatever was needed to get the surgery.
By about 9:30 a.m., word came that the surgery was back on. Since the operating room was in use, the new time for the procedure was about 1:30 p.m.
Cheryl Midkiff of PCHP said they weren’t part of the negotiations, but as far as PCHP is concerned, “At no time was it (the surgery) ever disapproved or retracted.”
The formal request for the surgery came in on Feb. 3, she said, and was approved Feb. 4.
Midkiff said the company’s relationship to the self-insured Lynchburg City Schools is as an administrator of benefits.
“They are responsible for the insurance piece of the claim,” said Midkiff. “We process the claims for them. We are not at risk for the payment of the claims.”
After the procedure was approved Feb. 4, she said, the reinsurer became involved in working with reimbursement.
A reinsurer is another layer of insurance self-insured groups can opt for to cover unexpected very high costs. Reinsurers get paid a very high premium to assume that risk. It is standard procedure for a reinsurer to be informed after a claim exceeds a specific dollar amount, said Robert E. Hurley, an associate professor of Health Administration at Virginia Commonwealth University.
Cynthia Page, chief financial officer for Lynchburg City Schools, said with its policy, reinsurance company Cairnstone comes in when a bill reaches $125,000. Last year, she said, the schools paid $250,000 for the reinsurance premium.
Midkiff, of PCHP, said that reimbursement was an issue between the hospital and Cairnstone. For high-dollar cases, PCHP must notify the reinsurer, she said.
PCHP did get involved on the morning of Feb. 8 to “help facilitate the surgery,” said Midkiff.
She said that what the family went through was unfortunate, but she doesn’t know why it happened.
“We weren’t there. We weren’t privy to those conversations.”
One of the sticking points was the auditing of the bill, Midkiff said.
“That is a common practice by the reinsurance carrier …. Just because it’s audited it does not mean it’s not going to be paid.
“I don’t know why it would hold up the surgery,” she said. “I don’t know who was holding up the process, the hospital or the doctor’s office.”
Keller, the Cairnstone vice president, said it is standard practice for the reinsurer to negotiate with the hospital.
However, he said, it never affected the timing of the treatment.
“My understanding is that PCHP authorized the surgery for the time originally set. And the authorization was never withdrawn by Piedmont or anyone else.
“In fact, PCHP confirmed with the hospital that the surgery remained scheduled for the morning of Feb. 8, at all times they were never aware that anyone had cancelled.”
Keller said, “It appears to me it is a miscommunication to the family, which understandably was upset. It sounded to me like the doctor’s office gave the family information that it had been cancelled.”
Eric Wagner, of the 900-bed Washington Hospital Center, said that they’ve tried to track down the people who had a role in Marlena Hodges’ situation.
He said “regrettably it looks as if the insurance company was communicating one thing to Mrs. Hodges and to their family, and communicating something very different to the hospital.”
As near as he can tell, said Wagner, the Hodges’ case got posted for surgery in early February, and the hospital began the process of financial clearing - Hodges was not from the Washington area, and the hospital did not routinely do business with PCHP.
The first questions they got from PCHP, said Wagner, were about the nature of the surgery, if it’s experimental or FDA approved, what drugs were being used, how much they cost.
“We never got clearance from the insurance company (PCHP) during the course of the conversation,” he said.
The day before the scheduled surgery, said Wagner, PCHP’s case manager asked how much the whole episode of care would cost. The hospital’s managed care team “did their best job to come up with an estimate,” said Wagner. “The case manager said this is very expensive, we’re going to have to get the reinsurance company involved.”
Those discussions continued into the evening.
“The reinsurer was haggling with what they were trying to pay us,” Wagner said.
No conclusion was reached, said Wagner, “not until the morning of the eighth until a senior member of the team had a conversation directly with the president of PCHP that there was finally an agreement with PCHP to pay for the care.”
That morning the faxed approval came in that Marlena Hodges could be admitted and PCHP would pay for her care.
The puzzling thing, Wagner said, was that the reinsurer was involved on Feb. 7 in financial discussions, “but the actual arrangement was between ourselves and PCHP.”
Marlena Hodges’ surgery began at about 1:30 p.m. and continued for about 11 hours.
Her father, Delmus Phelps, worries about what lies ahead.
“If she continues to have future surgeries, how much trouble are we going to have?”
Hodges also said the outpouring of caring by churches and others in the community who know the families is overwhelming.
But no one involved will forget the episode or the battle for the surgery.
“It was a very disturbing thing to happen,” said Tom Hodges. “I still feel that there wasn’t due diligence, certainly on someone’s part, to make sure things were right and that the actual transaction of having the surgery and getting her what she needed should have been transparent to the insured. And it wasn’t.
“She was put through a lot of strain and stress. And that shouldn’t have happened.”
Cynthia T. Pegram
cpegram@newsadvance.com
February 27, 2005
Barely into the new year, Marlena Hodges got the diagnosis no one wants to hear - rare, aggressive cancer.
At age 24 and a fifth-grade teacher at Perrymont Elementary School, she had not yet reached her second wedding anniversary with her husband Jeff.
A routine January visit to the doctor led to a cascade of referrals to specialists then a diagnosis of ovarian cancer - soon changed to an even rarer disease in young women, desmoplastic small round-cell tumor.
“It’s so rare, that it’s hard to find anybody who treats it,” said Jeff Hodges.
But they were able to.
Within five weeks, Marlena Hodges was admitted to a Washington hospital for surgery that doctors felt gave her the best chance.
And there was some comfort in having insurance through Lynchburg City Schools and access to the skills of a nationally known surgeon, Dr. Paul Sugarbaker, who specializes in treating the rare cancer.
Their hopes were focused on the surgery set for Feb. 8.
Then came crushing news on the eve of the surgery: It wasn’t going to happen.
The last-minute turndown stunned loved ones gathered in Washington and was especially brutal for Marlena, already fragile from the fast-growing cancer.
A battle by her family with the insurers followed, one that ultimately won approval for the surgery. She remains hospitalized and is undergoing chemotherapy.
Their fight sheds light on the rough edges where insurance plans meet high-cost health care.
Tom Hodges, an insurance agent and broker for life and health insurance, is Jeff Hodges’ father. He used every resource and contact he could think of to get the surgery back on track.
“I shouldn’t have had to have done everything I know to push the system,” said Hodges. “I shouldn’t have had to call my lawyer to get the right she was guaranteed when she paid her premiums.”
And so far, no one can say why the young woman was put through turmoil at the 11th hour because of negotiations between the three main players in determining coverage: Lynchburg’s Piedmont Community Health Plan (PCHP), which is the benefits administrator for the Lynchburg City School’s self-insured health plan; Miami-based Cairnstone, which represents the policy’s reinsurer on high-cost medical cases; and the Washington Hospital Center, where the surgery was performed.
But all agree patients shouldn’t have to go through a last-minute delay.
“This should not happen,” said Eric Wagner, senior vice president of managed care for the not-for-profit MedStar Health, which owns Washington Hospital Center.
“I can’t tell you for sure what actually occurred,” said Cheryl Midkiff, a spokesman for PCHP, a managed healthcare organization owned by Centra Health and 250 Lynchburg-area physicians.
“From this end, we approved it. And authorized it. And from our understanding it was going to happen.’’
And Jim Keller, Cairnstone vice president of operations, also said his company did not know how the denial was made.
“We’re in the background as reinsurers, not making those decisions,” he said.
“I’m not sure who cancelled it. It wouldn’t have been us. It wouldn’t have been PCHP, they’d already approved it.”
The Hodges thought everything was on track until Feb. 7, the day before the surgery was scheduled.
Tom and his wife Dianne went over to the surgeon’s office to pick up instructions and prescriptions for their daughter-in-law, who was expecting to be admitted to surgery early the next morning.
“It was quarter to five, and we walked in and they told us to sit down, they were having problems with negotiations with PCHP,” said Dianne Hodges.
Soon the Hodges were joined by Jeff and Marlena. A member of the surgeon’s office staff “came out and said, ‘they have turned you down,’” Dianne Hodges recalled.
The news was shattering for Marlena.
Both Hodges and Delmus Phelps, Marlena’s father, called Dr. David Smith, PCHP medical director.
“We were really scared,” said Phelps. “And I was shocked that they would cancel that late.”
He called people he thought would know people who could help. Local legislators were contacted.
Phelps contacted a lawyer, who said to let them know if nothing had changed by 7:30 a.m. the next day. The next morning, said Hodges, that call was made.
About 8 a.m., Jeff and Tom Hodges went to the hospital’s administrative offices and talked to the hospital president, James Caldas.
He assigned a patient advocate to them, Tom Hodges said, and told them she would do whatever was needed to get the surgery.
By about 9:30 a.m., word came that the surgery was back on. Since the operating room was in use, the new time for the procedure was about 1:30 p.m.
Cheryl Midkiff of PCHP said they weren’t part of the negotiations, but as far as PCHP is concerned, “At no time was it (the surgery) ever disapproved or retracted.”
The formal request for the surgery came in on Feb. 3, she said, and was approved Feb. 4.
Midkiff said the company’s relationship to the self-insured Lynchburg City Schools is as an administrator of benefits.
“They are responsible for the insurance piece of the claim,” said Midkiff. “We process the claims for them. We are not at risk for the payment of the claims.”
After the procedure was approved Feb. 4, she said, the reinsurer became involved in working with reimbursement.
A reinsurer is another layer of insurance self-insured groups can opt for to cover unexpected very high costs. Reinsurers get paid a very high premium to assume that risk. It is standard procedure for a reinsurer to be informed after a claim exceeds a specific dollar amount, said Robert E. Hurley, an associate professor of Health Administration at Virginia Commonwealth University.
Cynthia Page, chief financial officer for Lynchburg City Schools, said with its policy, reinsurance company Cairnstone comes in when a bill reaches $125,000. Last year, she said, the schools paid $250,000 for the reinsurance premium.
Midkiff, of PCHP, said that reimbursement was an issue between the hospital and Cairnstone. For high-dollar cases, PCHP must notify the reinsurer, she said.
PCHP did get involved on the morning of Feb. 8 to “help facilitate the surgery,” said Midkiff.
She said that what the family went through was unfortunate, but she doesn’t know why it happened.
“We weren’t there. We weren’t privy to those conversations.”
One of the sticking points was the auditing of the bill, Midkiff said.
“That is a common practice by the reinsurance carrier …. Just because it’s audited it does not mean it’s not going to be paid.
“I don’t know why it would hold up the surgery,” she said. “I don’t know who was holding up the process, the hospital or the doctor’s office.”
Keller, the Cairnstone vice president, said it is standard practice for the reinsurer to negotiate with the hospital.
However, he said, it never affected the timing of the treatment.
“My understanding is that PCHP authorized the surgery for the time originally set. And the authorization was never withdrawn by Piedmont or anyone else.
“In fact, PCHP confirmed with the hospital that the surgery remained scheduled for the morning of Feb. 8, at all times they were never aware that anyone had cancelled.”
Keller said, “It appears to me it is a miscommunication to the family, which understandably was upset. It sounded to me like the doctor’s office gave the family information that it had been cancelled.”
Eric Wagner, of the 900-bed Washington Hospital Center, said that they’ve tried to track down the people who had a role in Marlena Hodges’ situation.
He said “regrettably it looks as if the insurance company was communicating one thing to Mrs. Hodges and to their family, and communicating something very different to the hospital.”
As near as he can tell, said Wagner, the Hodges’ case got posted for surgery in early February, and the hospital began the process of financial clearing - Hodges was not from the Washington area, and the hospital did not routinely do business with PCHP.
The first questions they got from PCHP, said Wagner, were about the nature of the surgery, if it’s experimental or FDA approved, what drugs were being used, how much they cost.
“We never got clearance from the insurance company (PCHP) during the course of the conversation,” he said.
The day before the scheduled surgery, said Wagner, PCHP’s case manager asked how much the whole episode of care would cost. The hospital’s managed care team “did their best job to come up with an estimate,” said Wagner. “The case manager said this is very expensive, we’re going to have to get the reinsurance company involved.”
Those discussions continued into the evening.
“The reinsurer was haggling with what they were trying to pay us,” Wagner said.
No conclusion was reached, said Wagner, “not until the morning of the eighth until a senior member of the team had a conversation directly with the president of PCHP that there was finally an agreement with PCHP to pay for the care.”
That morning the faxed approval came in that Marlena Hodges could be admitted and PCHP would pay for her care.
The puzzling thing, Wagner said, was that the reinsurer was involved on Feb. 7 in financial discussions, “but the actual arrangement was between ourselves and PCHP.”
Marlena Hodges’ surgery began at about 1:30 p.m. and continued for about 11 hours.
Her father, Delmus Phelps, worries about what lies ahead.
“If she continues to have future surgeries, how much trouble are we going to have?”
Hodges also said the outpouring of caring by churches and others in the community who know the families is overwhelming.
But no one involved will forget the episode or the battle for the surgery.
“It was a very disturbing thing to happen,” said Tom Hodges. “I still feel that there wasn’t due diligence, certainly on someone’s part, to make sure things were right and that the actual transaction of having the surgery and getting her what she needed should have been transparent to the insured. And it wasn’t.
“She was put through a lot of strain and stress. And that shouldn’t have happened.”
Teacher winning fight
Teacher winning fight with rare type of cancer
By Cynthia T. Pegram
cpegram@newsadvance.com
May 23, 2006
A young Lynchburg teacher is doing well at Duke University following a bone marrow transplant last week.
Marlena Hodges, 25, was diagnosed more than a year ago with a rare, aggressive form of cancer, Desmoplastic Small Round Cell tumor.
At Perrymont Elementary School, Hodges taught 5th grade. She was the subject a February 2005 feature story in the News & Advance when insurance problems threatened to delay her first major surgery at a Washington, D.C., area hospital.
A June 2 benefit golf tournament has been set up to help defray some of the major expenses that have come with her complex cancer care.
“Basically, she’s doing great,” said her husband, Jeff. The transplant seems to working well enough to be considered ahead of schedule, he said Monday from Durham, N.C. “She’s kind of a week ahead of things ... She’s complication free and doing as well as possible.”
Hodges underwent a number of surgeries before the bone marrow transplant.
She hopes to be released next week from the hospital, but will have to remain in the Durham area for about six weeks.
She has a website www.caringbridge.org.
To enter the website, click visitor, and use the password marlenahodges. Her husband, Jeff says she likes to get e-mail.
The “Marlena Hodges Benefit Golf Tournament” will be June 2 and begin with a 12:30 p.m. lunch and check-in at London Downs Golf Course. Tee off begins at 1:30 p.m.
Cost is $75 per player or $300 per team. Strings and mulligans are $5 each.
Included in the cost is lunch, green and cart fees – plus closest to the line, closest to the pin, longest putt and more. Specific prizes will include a Pontiac G6, 36 dozen-golf balls, a GM car care kit, MIKE driver, and a five-day Acapulco vacation for two. All donations and fees for golfing and hole sponsorships should be made to Timberlake United Methodist Church (TUMC).
For more information contact Tom Hodges (Marlena’s father-in-law) at (434) 401-1122 or the church at (434) 239-1348.
By Cynthia T. Pegram
cpegram@newsadvance.com
May 23, 2006
A young Lynchburg teacher is doing well at Duke University following a bone marrow transplant last week.
Marlena Hodges, 25, was diagnosed more than a year ago with a rare, aggressive form of cancer, Desmoplastic Small Round Cell tumor.
At Perrymont Elementary School, Hodges taught 5th grade. She was the subject a February 2005 feature story in the News & Advance when insurance problems threatened to delay her first major surgery at a Washington, D.C., area hospital.
A June 2 benefit golf tournament has been set up to help defray some of the major expenses that have come with her complex cancer care.
“Basically, she’s doing great,” said her husband, Jeff. The transplant seems to working well enough to be considered ahead of schedule, he said Monday from Durham, N.C. “She’s kind of a week ahead of things ... She’s complication free and doing as well as possible.”
Hodges underwent a number of surgeries before the bone marrow transplant.
She hopes to be released next week from the hospital, but will have to remain in the Durham area for about six weeks.
She has a website www.caringbridge.org.
To enter the website, click visitor, and use the password marlenahodges. Her husband, Jeff says she likes to get e-mail.
The “Marlena Hodges Benefit Golf Tournament” will be June 2 and begin with a 12:30 p.m. lunch and check-in at London Downs Golf Course. Tee off begins at 1:30 p.m.
Cost is $75 per player or $300 per team. Strings and mulligans are $5 each.
Included in the cost is lunch, green and cart fees – plus closest to the line, closest to the pin, longest putt and more. Specific prizes will include a Pontiac G6, 36 dozen-golf balls, a GM car care kit, MIKE driver, and a five-day Acapulco vacation for two. All donations and fees for golfing and hole sponsorships should be made to Timberlake United Methodist Church (TUMC).
For more information contact Tom Hodges (Marlena’s father-in-law) at (434) 401-1122 or the church at (434) 239-1348.