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My DH wanted me to ask if anyone here has succeeded in getting their insurance to cover the Enterolab tests and if so, what insurance company do you have. If you aren't comfortable posting an answer, please PM me.
Connie
Has anyone had the Enterolab tests covered by insurance?
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Has anyone had the Enterolab tests covered by insurance?
Resolved MC symptoms successfully w/L-Glutamine, Probiotics and Vitamins, GF since 8/'09. DX w/MC 10/'09.
Connie,
Here are a couple of examples, but they don't list their insurance company, and a couple of these members haven't posted in a while. Scroll down to Jan's post on the first thread:
http://www.perskyfarms.com/phpBB2/viewt ... rance+paid
This thread contains posts from two members whose insurance companies paid for their tests - the first post, and the last one in the thread:
http://www.perskyfarms.com/phpBB2/viewt ... rance+paid
Another member mentioned that her insurance company said that they would pay for the tests, but when they found out that her doctor didn't order them, they declined to pay.
Tex
Here are a couple of examples, but they don't list their insurance company, and a couple of these members haven't posted in a while. Scroll down to Jan's post on the first thread:
http://www.perskyfarms.com/phpBB2/viewt ... rance+paid
This thread contains posts from two members whose insurance companies paid for their tests - the first post, and the last one in the thread:
http://www.perskyfarms.com/phpBB2/viewt ... rance+paid
Another member mentioned that her insurance company said that they would pay for the tests, but when they found out that her doctor didn't order them, they declined to pay.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Hi Connie,
My Entrolab test were covered by insurance company. I have Magnacare. They paid almost the entire bill minus my copay! I had called to see if I could get reimburessed at first they said no then after explaining to them my health problems and seeing that I had alredy had a lot of test done for MC they finally did cover it! Just make sure you have a diagnosis code and procedure codes! It should be covered! Good Luck
Robin
My Entrolab test were covered by insurance company. I have Magnacare. They paid almost the entire bill minus my copay! I had called to see if I could get reimburessed at first they said no then after explaining to them my health problems and seeing that I had alredy had a lot of test done for MC they finally did cover it! Just make sure you have a diagnosis code and procedure codes! It should be covered! Good Luck
Robin
Thanks for the responses thus far, I will compile notes. Lesley, FYI, my DH is a paramedic. He hasn't been employed by an ambulance service for over 15 years now, but when he was they would go out of their way to avoid a Kaiser hospital when they had a patient in crisis. My daughter had Kaiser for years when she was doing medical research and suffering from IBS, virtually EVERYthing they did/prescribed for her illness, were things that exacerbated her illness, which turned out to be GS. They put her on massive antibiotics, repeatedly. This is part of why she is now in nursing school. Find a new insurance policy, IMO, these people aren't healers, unless they have improved in how they treat patients.
Resolved MC symptoms successfully w/L-Glutamine, Probiotics and Vitamins, GF since 8/'09. DX w/MC 10/'09.
Connie,
I am also a paramedic, an OT, and I worked in the system for 15 years in the states and many more in Israel. The difference between the systems is incredible.
I belonged to Group Health when I lived in Seattle because that was the insurance I had. When I got hurt and then sick I lost my insurance, of course (isn't that a very familiar story?) and had to go onto COBRA. I moved to CA because I had been putting my son through school, and couldn't afford COBRA and rent, so we were going to share until I go on my feet. Long story.
Group Health was affiliated with Kaiser. The first few years I was very satisfied. I had some good doctors for what I had, and they were very good to me. I was declared disabled by Social Security and went onto Medicare.
Up till MC it was pretty OK, though I wanted to get off the meds and couldn't find anyone there to help me. Then came this whole illness, and I have been more and more disenchanted with the doctors at Kaiser. They are more and more busy, more distracted, and not helpful to me at all with this disease. I got dx'd, so I have something to be thankful for. But since then I have been less than happy with them. I can't find anyone to talk to about it, and my PCP, who was very nice up to this, now makes me feel awful. She does treat me as though she feels I am a hypochondriac. When I went to see her to ask her to help me find another GI she was almost aggressive when she asked me how I know I have MC. She wouldn't believe me until she found the dx in the notes.
No, I am not happy. Medicare enrollment came early this year, and I was trying to get in with a different GI. I have to wait now before I can change, but change I will!
I am also a paramedic, an OT, and I worked in the system for 15 years in the states and many more in Israel. The difference between the systems is incredible.
I belonged to Group Health when I lived in Seattle because that was the insurance I had. When I got hurt and then sick I lost my insurance, of course (isn't that a very familiar story?) and had to go onto COBRA. I moved to CA because I had been putting my son through school, and couldn't afford COBRA and rent, so we were going to share until I go on my feet. Long story.
Group Health was affiliated with Kaiser. The first few years I was very satisfied. I had some good doctors for what I had, and they were very good to me. I was declared disabled by Social Security and went onto Medicare.
Up till MC it was pretty OK, though I wanted to get off the meds and couldn't find anyone there to help me. Then came this whole illness, and I have been more and more disenchanted with the doctors at Kaiser. They are more and more busy, more distracted, and not helpful to me at all with this disease. I got dx'd, so I have something to be thankful for. But since then I have been less than happy with them. I can't find anyone to talk to about it, and my PCP, who was very nice up to this, now makes me feel awful. She does treat me as though she feels I am a hypochondriac. When I went to see her to ask her to help me find another GI she was almost aggressive when she asked me how I know I have MC. She wouldn't believe me until she found the dx in the notes.
No, I am not happy. Medicare enrollment came early this year, and I was trying to get in with a different GI. I have to wait now before I can change, but change I will!
I have Security Health Plan and my Enterolab test was covered including the shipping charges. I just got the reimbursement check in the mail last week. I would call and verify everything first as you have to pay for it up front then submit the charges to your insurance. Enterolab was wonderful with providing the codes and paperwork needed. It is a joint effort between your GI and Enterolab. Your doctor will have to write a RX for labs and fax it to Texas and then Enterolab can generate the paperwork needed for your insurance company. My paperwork needed to have my GI's information on it, not mine (as ordering the test). My insurance company told me that I would have full coverage (my plan pays 100% for labs) as long as there wasn't another in-network provider that could perform the test. There aren't so everything was good. It's just being able to get your doctor to write the order. My GI had brought up being tested again for celiac disease through a blood test a few months prior (I'd already had 2 done w/in the five years I've been dealing with this) so maybe that was why he agreed. I was disappointed because he only approved Panel A and I requested Panel C too. I printed off all the info detailing the tests and costs involved and faxed them to his office to review. Looking back, I regret not paying the extra out of pocket to have the Panel C done but I didn't have the extra money at the time. I anticipated a denial and a headache trying to get the claim paid but I had none.
Good luck- for as much as we pay for premiums, co-pays, etc. it's a dirty shame that we end up paying so much out of pocket for the "alternative" medicines. I was relieved that after the thousands of dollars spent on other labs and doctor referrals that I knew wouldn't help, that I finally got one test that hopefully will help on the road to management of this nasty beast. Like Lesley, I am treated as a hypochondriac and it is frustrating and insulting to say the least.
Good luck- for as much as we pay for premiums, co-pays, etc. it's a dirty shame that we end up paying so much out of pocket for the "alternative" medicines. I was relieved that after the thousands of dollars spent on other labs and doctor referrals that I knew wouldn't help, that I finally got one test that hopefully will help on the road to management of this nasty beast. Like Lesley, I am treated as a hypochondriac and it is frustrating and insulting to say the least.
My testing was covered by my insurance because when my PCP wrote out the script
it was stated that there wasn't any GI's in my area that could do this type of testing.
Get the script, then call whoever your medical insurance carrier is and also state the reasoning why.
Love
Dee~~
it was stated that there wasn't any GI's in my area that could do this type of testing.
Get the script, then call whoever your medical insurance carrier is and also state the reasoning why.
Love
Dee~~
"What the heart gives away is never gone ... It is kept in the hearts of others."