This is topic ivig- how are you getting it approved by ins? in forum Medical Questions at LymeNet Flash.


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Posted by njgirl14 (Member # 14174) on :
 
for what dx and/or reasons are your drs getting this approved?

i go denied from ins.
 
Posted by losferwrds (Member # 19741) on :
 
Did you get an IGG panel done, what are your numbers for the 4 subclasses?

You may want to PM lymetwister he just started with it, but he's got the POTS, Disautomania, encephalatis etc etc etc, so I think his was pretty much an open and shut case.
 
Posted by davidx (Member # 8326) on :
 
Hi NJgirl-

I have been on IVIG for several months for neuropathy caused by what the dr thinks is an autoimmune condition.

I think different insurance companies may have different criteria so you might want to check with yours to see what they require. My insurance company asked for lab results and appointment notes before paying the bills.

Do you know why they denied you? Was there a letter or any other documentation explaining why?

Maybe you could talk to your dr and see if there's anyway to appeal the denial. Some people seem to have success with that route.

Good luck and I hope things work out!

-David
 
Posted by seekhelp (Member # 15067) on :
 
Are LLMDs willing to run the IgG subclass panel ever? I'm interested in my numbers.
 
Posted by Parisa (Member # 10526) on :
 
My husband's was approved for dermatomyositis.
 
Posted by Dawn in VA (Member # 9693) on :
 
Seek, even a regular GP might run them for you if you used a bit o' charm.
I would guess that LLMD's would (mine did without any protest) upon request.
 
Posted by losferwrds (Member # 19741) on :
 
quote:
Originally posted by seekhelp:
Are LLMDs willing to run the IgG subclass panel ever? I'm interested in my numbers.

Mine did as part of my initial blood work, only my subclass 3 was low
 
Posted by kimp (Member # 19339) on :
 
Our insurance would only approve 4 weeks of IV's. Said anything more is experimental for lyme disease. Tried an appeal and still came back denied so switched to oral, which they are still paying for.
 
Posted by Littlesprout (Member # 7406) on :
 
Call your ins comp, see what conditions for covered, then find a doc who will give you that diagnoses,
Play the game
 
Posted by Peedie (Member # 15355) on :
 
Play the game - but if they already know what your cards are - Positive Lyme is reported to the CDC/health dept.
Is this information available to the Health Insurance Co.?
 
Posted by Snailhead (Member # 18091) on :
 
How about coinfections? Have you been tested for those? That dx may help. God bless you.
 
Posted by njgirl14 (Member # 14174) on :
 
my dr is going for neuropathy. biopsy results slightly abnormal. this is 2nd try.
 
Posted by davidx (Member # 8326) on :
 
Peedie-

I dont know who has access to what but a lot of insurance companies believe lyme is cured after 4 weeks so in this case maybe it works in our favor? The neurologist I see called my auto-immune issues "post-lyme" and maybe this has helped in terms of coverage for ivig? So they won't cover IVIG for lyme, but for auto-immune they might.

NJgirl-

What biopsy did you have done? I had abnormal skin biopsies for a few years (very low nerve fiber density) along with other things. I hope you have better luck on the 2nd try.
 
Posted by njgirl14 (Member # 14174) on :
 
davidx

i had nerve biopsies done on both ankles. i see you're from ct. is your dr dr k the neuro?
 


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