Considering providing my LLMD receipts to insurance for reimbursement. I sense, from reading, that this might not be a good idea. It would be raising my hand and saying I have Lyme. I don't totally understand, though. Can anyone explan? I get that it is political, but see that it is complex. Would/do you send your bills to insurance? Why? Why not?
Posted by In19944 (Member # 34272) on :
if you've tested even a couple bands positive on a w. blot, your insurance company knows anyway. if you have a clinical diagnosis only, maybe you'd want to go under the radar and pay for treatment yourself(i wouldn't)..
this is only my experience. i tested pos for two bands and they already knew before i sent in receipts from my llmd.
Posted by Lymetoo (Member # 743) on :
I did and got quite a bit of reimbursement. Never had a problem in 4 yrs of treatment.
Posted by TF (Member # 14183) on :
I always submittted my bills. No problems.
Posted by YinYang (Member # 36358) on :
That is good news, I suppose I was worrying over nothing. Thank you...
Posted by desertwind (Member # 25256) on :
I do not understand why not to submit bills if you have out of network benefits???
Lyme is not something I am trying to hide - nor is my LLMD. He refers me to others specialists for things related to my lyme disease (cardiologist, allergist etc..). Never had a problem.
Either the insurance pays or they don't.
Posted by Catgirl (Member # 31149) on :
I think it's when people start getting into long term IV use when it becomes a problem ($$). Remember the guy in Under Our Skin? His insurance company didn't want to pay for him going to see Dr. Burrascano in NY anymore (he lived in CA). So they sent him to a doc in SF who ultimately said that he didn't have lyme.
Aren't insurance companies the ones behind funding universities and the idsa for inadequate/limited lyme tests to argue their point so they don't have to pay for long term lyme treatment?
In1944 has a good point. Perhaps when TF & Lymetoo were treated it wasn't as big of an issue as it is now. Maybe that was before lyme exploded to the point it has now (paid with no issues).
Posted by Rene (Member # 4870) on :
I would not hesitate to turn in my receipts for reimbursement. My insurance paid without much issue. I did have to write an appeal for IV treatment and then they paid that too.
Posted by gmb (Member # 23562) on :
YY,
Check your deductable on out of network Dr visits. If your LLMD visit is $250, the insurance company will most likely only apply $120 towards your deductable(their contracted rate with Dr's in the network).
I still submit anyway with a $4,000 out of network deductable, even though I may not reach it.
gmb
Posted by bcb1200 (Member # 25745) on :
I always submit mine.
Posted by TF (Member # 14183) on :
Lyme was a big deal in 2003-2005 when I was getting my lyme treatment.
I remember my second lyme doctor saying, "I'd put you on IV but the insurance company would give me a fit." So, he gave me oral medications instead.
Also, my pcp refused to see me or help me in any way after the 30 days of doxy he gave me in response to my positive LabCorp lyme test.
When he gave me the doxy he said, "I hope I can help you."
So, the atmosphere was terrible then as now. The fighting has been raging since the early 90s when Burrascano testified before the U.S. Congress. He was hauled up on charges within 2 years of that testimony, just as he predicted.
He told Congress he feared retaliation for his testimony. So, that was the atmosphere back then. At least now a number of states have passed laws that allow doctors to treat lyme disease long-term without reprisal.