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» LymeNet Flash » Questions and Discussion » Medical Questions » Question: IgeneX and insurance

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Author Topic: Question: IgeneX and insurance
Starfall1969
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I have to get bloodwork done through IgeneX.

I know you have to prepay that and all, that they don't do insurance.

But do they send you something to send to your insurance company for reimbursement?

And do you have to request this, or do they just send it to you?

Thanks!

Posts: 1682 | From Dillsburg, PA | Registered: Sep 2008  |  IP: Logged | Report this post to a Moderator
Michelle M
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They will automatically send you receipts to submit to insurance. No need to do anything extra! My Blue Cross at the time gave me about $20 reimbursement, the pathetic pills!!
Posts: 3193 | From Northern California | Registered: Apr 2005  |  IP: Logged | Report this post to a Moderator
Blackstone
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For what it is worth, the full cost of the test was credited to my BC/BS deductible, when I submitted my receipt.

Back when I had Tricare (as a dependent) they gave me full reimbursement.

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asummers
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I have BCBS and I was advised to apply for a 'waiver.' I forget the official name for it due to brain fog. If you are interested you can PM me and I will look it up in my medical binder at home.

Basically, I applied for this waiver prior to getting the Igenex test. Someone from the insurance company called me and asked me 'why I had to use Igenex vs Quest.' These types of questions are standard.

They want to know why you can't use a lab/doctor covered under insurance. You basically have to prove to them why you need to use a speciality lab/doctor.

I was told by BCBS that when they called back to be 'very convincing' and prove why you need to go out of the network. Well, I don't think the person on the other end of the phone knew what hit them.

I started explaining the difference between WB & ELISA and the different bands, ect. I went on & on about the difference. Needless to say my research paid off.

Well, I got the lab work covered as if it was an in-network lab. I think I only had to pay 50.00 out of pocket.

I paid Igenex and then BCBS reimbursed me.

I also went this route for my LLMD appointments as well. They reimburse me 175.00 after I pay the doctor.

I had to apply for another waiver to cover the doctor appointments, explain why I was going to a LLMD vs a PCP.

The key is getting the waiver before you get the treatment. It doesn't get back dated.

Posts: 379 | From Sydney, Australia | Registered: Nov 2008  |  IP: Logged | Report this post to a Moderator
bettyg
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summers,

thx for telling us about WAIVERS; i hadn't heard of this before.

if you are on MEDICARE; IGENEX FILES for that; NO PREPAY THEN!

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Amy C
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I had Medical Mutual last year and Aetna this year.

Both of them I just printed a claim form on their website, filled it out, and mailed it with a copy of the receip that Igenex sent me.

I received my full 80% back! It was a shock! LOL

--------------------
My lyme disease blog:
http://lymetimes3.blogspot.com/
One BIG Lyme family!
I tested CDC + 10/08
My mom Igenex + 11/08 & My brother Igenex + 4/09, My 2 boys some + & IND bands, clinical diagnosis 3/09 (youngest has Aspergers too)

Posts: 470 | From Painesville, Ohio | Registered: Mar 2009  |  IP: Logged | Report this post to a Moderator
Starfall1969
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We have United HealthCare, so I'm not very confident of getting much of anything back from them.

I have trouble sometimes getting doctors who accept this insurane--apparently they don;t have a good track record.

Posts: 1682 | From Dillsburg, PA | Registered: Sep 2008  |  IP: Logged | Report this post to a Moderator
Amy C
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I was suprised that Aetna gave us all that back too. We have had a lot of troubles with them.

But I figured it was worth a try. We have 3 in our house with Lyme so it was expensive to test.

I just sent a few more to them from our Fry Lab co-infection tests. So we will see.

Good luck!

--------------------
My lyme disease blog:
http://lymetimes3.blogspot.com/
One BIG Lyme family!
I tested CDC + 10/08
My mom Igenex + 11/08 & My brother Igenex + 4/09, My 2 boys some + & IND bands, clinical diagnosis 3/09 (youngest has Aspergers too)

Posts: 470 | From Painesville, Ohio | Registered: Mar 2009  |  IP: Logged | Report this post to a Moderator
bettyg
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amy just brought up something,

geneal was saying since 2-4 of her family tested at ONCE, they were given a family discount; so ask about that if there is MORE THAN 1 TESTING...

i was reimbursed $43 or $34 out of $190 the 1st time.

on medicare 2nd time; paid in full.

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duke77
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quote:
We have United HealthCare
United paid for all of my tests a few years back. I have had no problems with United. Before that I had aetna and cigna, I have nothing good to say about those two companies. If you have seen the movie Sicko, United was one of the only large insurance companies not to have a segment dedicated to them. Michael Moore did mention that their CEO was making like 7 million a year though.
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Starfall1969
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duke77--Well, that's encouraging anyway.

Maybe for once something will work in my favor??? [Smile]

Posts: 1682 | From Dillsburg, PA | Registered: Sep 2008  |  IP: Logged | Report this post to a Moderator
Tiramisu
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Health America reimbursed my WB after about 10 phone calls and 6 months.

They requested more documentation from my PCP. Whatever notes they were given must have worked, but that's funny because I only saw this PCP for the first time and he really had very little insight on my condition.

If you have Health America, you need to keep calling them at every step to be sure they are moving on it.

Posts: 175 | From SW PA | Registered: Mar 2008  |  IP: Logged | Report this post to a Moderator
   

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