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» LymeNet Flash » Questions and Discussion » General Support » Dr. worried about ins co going after her

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Author Topic: Dr. worried about ins co going after her
BP-Ladybug
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My husband's doctor, who is an ND, has treated a number of Lyme patients. She has been to conferences, believes in chronic Lyme, and in long term antibiotic treatment as well as herbs, (Buhner). We have known her for more than 12 years both personally and as patients off and on.

She made a clinical diagnosis of my husband, plus some blood work. He just finished 5 weeks of an antibiotic plus IV's of supplements once or twice a week. He became extremely weak, headache, EXTREME fatigue, lost weight, pain. OMG herxing??? probably

Now he is taking a break from the ABX. Doing supplements, and doing a very expensive Igenix test for Lyme and coinfections. $1100.

Today she talked w me and expressed her concern about the insurance company going after her. It happened to her last year. sigh They went after her for using long term antibiotics.

I have been thinking about this a lot. So disturbing that we are dealing with a very sick patient and THEN have concerns of this nature.

After the Igenx tests she will pick another antibiotic most likely.

My thought - If it is a generic one should I just pay the low cash cost, and even get it at a separate pharmacy from the one we frequent? That way blue shield will not KNOW that he is on long term antibiotics. There is probably only a limited amount of time that she can keep coding as fatigue.

Perhaps at a future date there might be a more expensive antibiotic and we would try to get that paid through insurance and creative coding???

Is it ok that I am discussing this??
Ladybug

Posts: 47 | From Pacific Northwest | Registered: Jul 2011  |  IP: Logged | Report this post to a Moderator
Lymetoo
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I would consider the cash route myself. But I wonder how much they can find out about the case in other ways?? I don't know, really.

Just do NOT make ANY mention of where this dr is located in ANY of your posts. Be VERY careful. You may even want to remove this by tomorrow evening just to be sure.

---and better yet, remove your own location in your profile so that it does not show here.

Also let her know you will be paying cash so she can 'rest easy.'

--------------------
--Lymetutu--
Opinions, not medical advice!

Posts: 96222 | From Texas | Registered: Feb 2001  |  IP: Logged | Report this post to a Moderator
BP-Ladybug
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wow
you are serious aren't you
wow

wow do spies search the boards to find ways to discredit doctors??????

Posts: 47 | From Pacific Northwest | Registered: Jul 2011  |  IP: Logged | Report this post to a Moderator
Rumigirl
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This is so sad and so disturbing. But does it happen? You bet your boots!! And with what other illness does this happen??!! Probably none other.

Yes, Lymetoo is right. Be very careful. If this doesn't make you an advocate, I don't know what will! But at this point, I'm sure you are too busy with the task at hand: getting your husband well.

I pray things go well on all fronts here.

Get involved with your local Lyme Support Group, too, whether there is an in-person group or just online. That way you can get support with these issues from people "on the ground" locally.

Whew, this stuff is not to be believed---until you've seen it all too much.

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seibertneurolyme
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To protect a doctor the issue is not whether you pay cash or file with your insurance. The issue is whose name is on the scrip.

The powers that be can track every scrip a doc has written that is filled if they so desire.

The only reason to pay cash would be so the insurance company has no record of your husband getting the med. They get the diagnosis code from the office visit -- not from the scrip itself.

Bea Seibert

Posts: 7306 | From Martinsville,VA,USA | Registered: Oct 2004  |  IP: Logged | Report this post to a Moderator
Lymetoo
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Bea... they aren't that likely to go searching his scripts, I wouldn't think. They MIGHT .. but would have to have a reason to do so.

Ladybug... Read this:

http://flash.lymenet.org/ubb/ultimatebb.php/topic/1/108368

It is posted in a sticky near the top of the Medical Questions boar.

--------------------
--Lymetutu--
Opinions, not medical advice!

Posts: 96222 | From Texas | Registered: Feb 2001  |  IP: Logged | Report this post to a Moderator
   

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