Fibrospect not covered by insurance

[NancyPF]

Hey all,

I just wanted to post a warning about the Fibrospect test not being covered by PERS Blue Cross Insurance.

The test was ordered by my gastro back when I was first diagnosed.  Since I am 2b, she didn't opt for the biopsy.  She told me to call my insurance to be sure it would be covered, which I did and was told verbally that it would be covered, so I had the test.

Since that time I have been told by PERS that it is not covered, have been through a couple of appeals processes, and have had a final reply from them that it is considered "Investigational" and is not covered, whatever that means.

So for anyone thinking about having this very expensive blood test ($350) who has PERS Blue Cross, get preauthorization IN WRITING or you'll be paying for it out of your own pocket, like me.

Nancy

[NancyPF]

Hey Bill and Can Do,

Nice to hear from you.  Hope you're well.

I had the Fibrospect back in April before starting treatment and have been fighting with the insurance company ever since.  I have reached the end of my appeal process.  Not feeling real happy with my insurance company right now, and the company that does the test is screaming for payment, so I guess I'll have to pay it.  Don't have a lot of fight in me right now with tx and sx going on, so I'll probably just drop it and chalk it up to a learning experience.  Just wanted everyone to be aware that it could be a problem.

My doctor recommended Aquaphilic cream for the rash and Aveeno soap and lotion, so we'll see how that works.  It's not so bad that I'm being driven crazy, but just annoying and hard to sleep at night.

Thanks again for the info.

Nancy

[Bill1954]

Jeez, Zach; thanks for the heads up. I thought for certain they had received approval… I guess not. Here’s a quick read on biopsy vs. non-invasive tests that might be interesting (from 2007):

http://www.clpmag.com/issues/articles/2007-04_06.asp

“LabCorp licenses the FibroSure test from BioPredictive, SAS, a company based in Paris that focuses on the development of noninvasive liver diagnostics. FibroSure is not approved by the FDA but is available as a LabCorp offering. Turnaround is roughly 7 days, Faruki says.

Always good to see you post here, my friend—

Bill

[can-do-man]

Keep fighting them as they should cover it. My insurrance gave me no problem. Best of luck to you.

Bill, hope all is well with you, as for fibrosure being FDA approved they are not, only because they don't need to be.

cando

[Bill1954]

Hi Nancy,

I’m not sure if I’m interpreting your message correctly, but if your considering a Fibrospect/Fibrosure test *during* treatment, I’d be very careful that the manufacture supports this. My NP ordered a Fibrosure test during treatment; it apparently uses haptoglobin as one of the biochemical markers; this can be substantially affected by hemolysis. Neither my Hepatologist or former GI doc would apply any diagnostic weight to the results.

Additionally, although the surrogate tests have data supporting their use, in the real world, the results seem to have too much discordance with biopsy. They are supposedly rather accurate toward the ‘ends’ of fibrosis, but do not differentiate well for the ‘mid ranges’; i.e. F2 and F3. I’m unsure of the utility of Fibrospect on treatment… use caution, and make sure your confident of the utility before paying for the test, especially out of pocket.

I’m curious why the insurance balked payment on appeal; the tests are FDA approved? Hmm…

Regarding your rash, what does the doc say about this? I’ve never personally experienced it, but I’ve heard it can be brutal sometimes. Very few favorable reports from patients that have gotten much relief from dermatologist, either :o(. Probably fax the doc, and see what they can come up with. Take care—

Bill