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» LymeNet Flash » Questions and Discussion » Medical Questions » Anyone get BC/BS to pay for Igenex tests?

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Author Topic: Anyone get BC/BS to pay for Igenex tests?
RZR
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I called BC/BS to ask, but they needed procedure codes, which I didn't have.

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Tick bite May 2009
Diagnosed June 2009

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sammy
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I had to pay for the testing up front then submit forms for reimbursement afterward. BC/BS did end up reimbursing me for a small amount of what I paid.

If you've had the testing done, Igenex should be able to give you the codes and other information that you need to fill out your forms.

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ott70
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Same for me. Had to pay for it upfront and then BCBS reimbursed me. I recall being pleasantly surprised on the amount they reimbursed but I believe it was less than 50%. Without looking back through my records, I think Igenex supplies enough info to submit back to BCBS.
Posts: 194 | From Colorado | Registered: Nov 2008  |  IP: Logged | Report this post to a Moderator
bigstan
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BCBS Mich reimbursed at 70%, but had to pay Igenix first.

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HERX is a Four Letter Word!

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asummers
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I have BC/BS and I was able to get my Igenex tests and LLMD appointments paid for as an `in - network' provider by getting a waiver. I asked for the waiver and was connected to the Medical Services Advisory.

I am not sure if you have this benefit with your BC/BS policy. I had to call the medical services advisory and give her all my info (what labs/doctors I wanted to use). Then someone from medical services called me back and I had to explain to her why I needed to use a special lab/doctor. I was told that I had to be very convincing, so I wrote out a speech and used mostly medical terms and some verbiage off of the Igenex website. I was approved.

The key is, you have to get the approval before you have the tests done or go to the doctor. Then you pay out of your pocket and get reimbursed later.

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Tarav
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Thats a good question. The LLMD I found is covered on my insurance plan as a particpating DOc.

But I wonder of the lab work is covered???

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Stacyb
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Any one in the military = Tricare pays for Ignenex
testing of any kind. You do have to pay up from
and then summit the invoice. Also Igenex will then
pick up the rest of what Tricare does not. Just send Ignenex the E.O.B. (explanation of benefits)
after Tricare sends you a check.

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asummers
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All lab work that my LLMD requested was done at Physican's Reference Lab which BC/BS accepts. It was covered 100%.

There was an option to get labs done at the LLMD's office, but I was concerned that I wouldn't get reimbursed, so I took the order form to PR labs.

The key with the Medical Services Advisory is to call & get approval prior to getting lab work done at Igenex and going to the LLMD.

I still had to pay 150-200 dollars out of pocket to see my LLMD, but I saved 150 dollars with my waiver. I have the number for the medical services board if anyone is interested.

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randibear
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i didn't want bc to know i was testing for lyme. they could possibily use it against you (and they might now depending on how the new insurance goes) so i just bit the bullet and paid out of pocket.

mine was 480!!

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do not look back when the only course is forward

Posts: 12262 | From texas | Registered: Mar 2007  |  IP: Logged | Report this post to a Moderator
dmc
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People, it depends on your particular plan.

Every plan is different depending on what you or your employer chose.

I think Igenex ALWAYS has you prepay and self submit to your own insurance. Not sure if Igenex submits to medicare though.

I do know medicare reimbursed my parents 100% when they submitted for reimbursement.

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randibear
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i'm just paranoid. bc bs of texas is what i have. when i was submitting my bills they sent me a letter saying they were putting me a high risk category due to my bills and were going to assign a special case worker to me.

since then i pay out of pocket. and my doctor doesn't take insurance.

just figure if i ever have to change policies and i probably won't tho, i don't want to have any problems.

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do not look back when the only course is forward

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Lymetoo
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I got Aetna to pay, but it took 9 months of hounding them.

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--Lymetutu--
Opinions, not medical advice!

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Hopeful2010
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I didn't realize that BC BS could black ball you if you have a Lyme diagnosis. You guys are scaring me. I did receive a letter saying if you have special circumstances we can assign someone to you. I didn't realize that it might be because I have Lyme disease. How does anyone get their IVs covered if they don't have a Lyme diagnosis?
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seekhelp
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Why is Igenex so ruthless about not accepting any insurance, but accepts Medicare's crap reimbursement?
Posts: 7545 | From The 5th Dimension - The Twilight Zone | Registered: Mar 2008  |  IP: Logged | Report this post to a Moderator
Need Lots of Help
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Yes, they paid for my tests after I submitted them with the Igenex invoice. But, it was only about $25.00.

Procedure codes are on the invoice, or should be, mine were.

Shalome

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Jason21
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BC/BS initially refused to cover most of my Igenex testing, but I filled a simple appeal. They ended up paying for 100% of my first testing and about 2/3rds of my second testing.

Also, be aware Igenex will give you a 15% family discount.

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Igenex WB IgM 28+, 31IND, 34IND, 41+
WB IgG 30+, 31IND,39 IND, 41++++, 58+, 83-93IND
CD57 = 56
Prob infected since 2000
Doxy, Zith, Biaxin, Flagyl, Levaquin, Tindamax, Cipro
Highly Recommended: Trigger Point Therapy Workbook by Clair Davies

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Mathias
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I don't even bother submitting them to BCBS. Not worth the risk. They are not a very Lyme friendly provider.

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Mathias

Posts: 1242 | From New Jersey | Registered: Feb 2004  |  IP: Logged | Report this post to a Moderator
   

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