insurance denying

Hmmm having trouble getting approval for much needed cardio tests for interferon approval. Has anyone else run into this problem and does anyone know how long these test are good for before hep docs want new tests. If and went I get it approved I doubt I'll ever be able to take the test again. Something wrong in insurance land.....Private insurers...ugh

[Diane12855]

You might want to reapply for approval because I was just informed by my insurance co. that the new health care laws go into effect today which eliminates lifetime limits, pre-existing conditions, and other things that I used to have.  

Diane

[fretboard]

Maybe you could find a clinical trial or an agency such as an HIV clinic, Indian health center, Harm Reduction Services or some agency like that and stop worrying about whether insurance will pay for something.  It's just an idea, alot of ppl don't know it but alot of times you don't have to be Indian or have HIV to get heath assistance from one of those centers and you don't have to use drugs to go to Harm Reduction Services either.  You gotta get creative when looking for health care.  good luck

[meakea]

It might be a matter of getting your doc to give a better explanation of why the tests are needed.  Good luck.

[Bill1954]

I wholeheartedly agree with meakea that the doctor needs to review his orders and perhaps change the diagnostic coding; often, that makes all the difference in the world. Importantly, keep at them; call insurance and ask them what needs to be done on your end to make this work; call the doctor’s office as well; sometimes this is something his staff can correct over the phone.

Be persistent.

Good luck and let us know how it goes,

--Bill

[sunshines76]

I agree with Bill's advice. My insurance has been nothing but helpful. I ran into a problem like yours once, and it had to do with coding - a customer service rep from insurance company did help me out and I got approval after the order was resubmitted with the correct coding.

[streamline569]

Exactly what I found out. It has to do with doctor explain. It has to fit the criteria for the test. I didn't appeal this time because I was told to wait about 6 weeks before treatment so I don't have to repeat test. If I have to I'm prepared to pay out of pocket. That's how important I feel it is to just get all this done, but once only, an timing is everything......

[streamline569]

OMG Small wonders. I got my echo approved.....:)

[nygirl7]

Since you have decided even though you have cirrhosis you are not going to treat for a while and hope that someday the PIs come out you don't need to do the echo after all so you dont have to stress it anyways~

[meakea]

Glad you figured it out and got approved.  With all the coding involved between docs and insurance, there's bound to be an innocent mistake or ten now and then.