LymeNet Flash: Do you know what lab Dr. Jones uses?

This is topic Do you know what lab Dr. Jones uses? in forum Medical Questions at LymeNet Flash.

To visit this topic, use this URL:
https://flash.lymenet.org/ubb/ultimatebb.php/topic/1/32891

Posted by christelleny (Member # 6719) on :

Does anybody knows if Dr. Jones uses Igenex?

Posted by quic (Member # 5262) on :

Yes he does...and MDL.

Posted by jellyfish (Member # 7390) on :

All my daughters urine PCR go to MDL in Jersey.

Posted by susscho (Member # 7429) on :

What does the Urine PCR show and how much does it cost? I thought PCR results were not that accurate -- or is that just blood PCR testing?
Does anyone know exactly what tests Dr. Jones orders? His office sent me a kit for PCR testing of my baby girl's cord blood (which we had banked at birth) to have them run tests before our appt. in 4 months. I don't know if the blood bank will be able to send me a specimen that I will have to mix and send to MDL.....
May be a lot of work for not a necessary test -- thought Western Blots were better than other tests....

Posted by lymex5&counting (Member # 7202) on :

Does anyone know exactly what tests Dr. Jones orders?

Posted by lymex5&counting (Member # 7202) on :

[QUOTE]Originally posted by susscho:

Does anyone know exactly what tests Dr. Jones orders?

Oops! Wrong button. Hello again.

BTW I think that is great that you banked her cord blood.

I just realized I have her (my babys') Placenta in the freezer, hmmmmm....

He ordered Western Blots from IGeneX ($153 each kid ask for a group discount for your family. Ins paid 100%, but I had to pay upfront)

Blood and urine PCR's from MDL
for Lyme

Blood PCR's for Erlichia, Bartonella, Babesia, and Mycoplasma from MDL

(It was $1050 per kid at MDL, they are suppossed to be in network so it should be covered at 100%? I still haven't gotten a bill? First tests were done in Jan 05.)

And CBC w/diff and platelets, RPR, Chemistries, cardiolipin, Lyme Disease C6,
sedrate, ANA, liver panel, CMV, Immune Complex, HLA antigen tests,
Strep, Thyroid, Lymphocyte panels, DNase, etc, etc from Quest. (These were between $1250 and $2550 per child, only the oldest 3 had the extensive testing ins. paid 100%)

The coinfections from MDL were done 3 months before our 1st appt. All Negative.

Then the oldest 3 were redone at our 1st appt, again all Negative.

The 3 oldest are CDC positive at IGeneX on their Western Blots and the baby has lots of bands but didn't meet CDC criteria like me.

Ask your ins co for a waiver. Thru the MSA (medical service advisory dept) Mine pays for Dr Jones at PPO level with the waiver. You can also get waivers for the specialty labs if they won't cover it at 100%, it is better to get 90% than 80% for out of network.

Hope this helps. I am sure he tests different things depending on circumstances. Such as mode of transmission, geographical location, symptoms, history, etc.

Posted by fatigued15 (Member # 6437) on :

What do you mean by a waiver from the insurance company. I have problems with insurance paying anything out of network.

Funny I didn't get a bill from MDL from PCR tetsing done in Nov. 04. I was hoping they forgot.

Posted by lymex5&counting (Member # 7202) on :

quote:
Originally posted by fatigued15:
What do you mean by a waiver from the insurance company. I have problems with insurance paying anything out of network.
Funny I didn't get a bill from MDL from PCR tetsing done in Nov. 04. I was hoping they forgot.

If you pay out of pocket they don't reimburse you? Mine will pay out of network at 80% of the allowable charges. Which means I am responsible for the 20% plus anything over and above the "contracted" amount if it were contract.

But if they are in network they pay 90% of the "contracted" amount. So I am responsible for 10%.

Since Dr Jones is the only Pediatric Lyme Specialist in the Country. And I live in Texas he is further than my radius which I think is either 30 or 50 miles. So they are required to cover him at the PPO level. It takes about a 15 minute phone call, then they call you back and send you a letter. You need to wait to have the test or appt after the 10 days that the waiver may take to be effective. They do my labs for 3 months at a time and Dr's for 6 months at a time. Then I will call and renew before they expire.

As far as MDL they said it would take about 3 months for the billing but it has been 5 for our first round. And 2 for the next round. And I just sent my blood, breastmilk, and urine last week. Ins better pay or I owe them $8000.