Have most of you on long term IV therapy received extended coverage for the IVs, or are you self paying now? What are some secrets to getting past the "30 days" coverage b.s.? I have two other conditions that warrant IVs, jaw OM and sinusitis. I haven't been denied an extension yet but I'm getting my ducks in a row to do battle, if necessary. A bone infection is life threatening, so this is very important.
Posted by timaca (Member # 6911) on :
Check out www.lymetimes.org One of their past issues deals with insurance. You may be able to access it online.
I have used info from CDCs website (before it got changed...but there may still be useful stuff on it now); and also the Evidence Based Guidelines for the Treatment of Lyme Disease. I think you can google that, and come up with it. You can also get info off the ILADS site...particularly Dr. B's guidelines.
Whenever I write my insurance company, I keep copies of everything I send to them. I include info from the above sites (and keep copies of these too). I send my stuff to the insurance FedEx, so that I know that someone signs for it.
Good luck....I've been on IVs since June 9th, and have had to battle the insurance company every step of the way.
I even had Dr. F; probably the most objective doctor in the country say that I needed IVs and my insurance STILL denined it!
But, they are paying now. We'll see how long that lasts....but I will take them to court if necessary....
Good luck...
I'll work on insurance reform once I'm well from lyme!
Posted by Boomerang (Member # 7979) on :
bump bump bump........
Interested in hearing how to go about this process, to get the insurance company to admit and agree to the diagnosis. Since we went out of state to MO, the insurance company is denying coverage.
Posted by seibertneurolyme (Member # 6416) on :
Read my response to fiddler at this link -- maybe something there will help.
Also, try searching under someting like "insurance denial" or "insurance appeals" -- this has been covered several times in the past. Appeals can be won but it will take time and effort on your part.
Timica gave good advice. Keep copies of everything and a phone log if you make calls as well. Try to make friends with someone in the appeals dept and send all appeals to the same person.
Bea Seibert
Posted by achey (Member # 6284) on :
Having your doctor order that Iv is necessary and it can be done as an inpatient at insurance co expense or outpatient, and my insurance co decided to pay for outpatient....
If the doctor says it's necessary then it's so...the insurance co is NOT your dr...
Maybe I've been luckier with my doc and insurance co than most. It si a long journey with some of it. I didn't have problems with IV authorization, but it took months to get my kids oral meds covered.
Yes, keep records of every corospondance. CC copies of all coorspondances to all necessary parties. Become a thorn.. a polite thorn, but a thorn none the less... eventually you will find someone reasonable, fair and compassionate.
I hope this is all preventation investigation. Wish you well!
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