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'Really hard, emotionally, to swallow': Monroe County woman denied liver transplant in Atlanta

After qualifying medically, Blue Cross Blue Shield of Texas denied her financially, causing her family to figure out an on-going insurance nightmare.

MONROE COUNTY, Ga. — A Monroe County woman needs a new liver, but her insurance company says they won't pay for the procedure unless she jumps through a big hoop.

We visited her family to see what the hold up is and learn more about her story of hope and desperation.

A liver transplant is the only way for this young woman of three to survive, but her insurance provider of nine years refuses to allow the surgery in Atlanta.

Doctors diagnosed 32-year-old Erika Giduturi with bile duct cancer in August 2021. Without a new liver, she only has 6 to 12 more months to live.

"Knowing that last Christmas with my children could've been our last together, that's really hard, emotionally, to swallow," Giduturi said.

Giduturi qualified for the transplant list at Emory University Hospital after five months of treatment, clearing her medically, but they denied her financially.

"It's so frustrating, because I pay for insurance, and when it comes time that I needed it, it's like, 'We control where you can have that lifesaving surgery,'" Giduturi said.

Her insurance provider, Blue Cross Blue Shield of Texas, refuses to cover the surgery unless it takes place at what they call a "Blue Distinction Center." Georgia doesn't have one, and Giduturi says she wasn't aware of those specifics before qualifying in Atlanta.

"The concern now is not being able to meet the protocol at other centers," Giduturi said.

Now, she has to start the qualifying process all over again in Jacksonville, Florida, at the Mayo Clinic, five-and-a-half hours away. Giduturi's brother-in-law, Jonathan Pless, says it's been frustrating.

"Trying to seek compassion from Zachry Group is not the correct way to go, apparently," Pless said, "Even though on their website they insist they are family-minded and love their employees."

"Every day that I am not on the transplant list is another day that everything could grow," Giduturi said.

If the cancer spreads, she will no longer qualify for a liver transplant.

There's no guarantee she'll pass the pre-transplant requirements in Florida like she did in Georgia, but if she does, it'll be a few weeks before doctors place her on the transplant wait list.

Then, she'll need to match with an organ donor.

Giduturi said, "What I would like to happen is for you to be able to have lifesaving surgery where you need it, close to you where you have family support."

We reached out to Zachry Group and Blue Cross Blue Shield of Texas.

Zachry Group said:

"As a result of Health Insurance Portability and Affordability Act (HIPAA) privacy requirements, we are not permitted to comment on the health of our employees, or dependents, covered in our Blue Cross and Blue Shield of Texas health plan. The health and wellbeing of our employees and their families are our top priorities. When healthcare needs arise, we work diligently with our members to provide support and information regarding coverage. Blue Cross and Blue Shield of Texas determines policies related to where covered procedures and services are provided."

Blue Cross Blue Shield of Texas said:

"Out of respect for our members’ privacy, we do not comment on individual member situations. We are committed to providing our members access to safe, appropriate and effective health care that is backed by our dedication to evidence-based medicine and the highest value treatment options. Coverage decisions are based on sound clinical research. Our medical team collaborates with physicians and researchers to constantly review the effectiveness of various medical treatments to produce high quality and safe outcomes. We also are committed to maintaining a robust network of providers so that our members can have access to affordable, evidence-based treatments and quality care. Depending on the member’s plan, available providers may include Blue Distinction Centers that are recognized for offering quality care, treatment expertise and better overall patient results.  By doing so, we are being good stewards of our members’ healthcare dollars while providing access to a wide choice of providers."

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