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» LymeNet Flash » Questions and Discussion » Medical Questions » Lyme Treatment & Insurance Battle with Blue Cross in CA

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Author Topic: Lyme Treatment & Insurance Battle with Blue Cross in CA
jam338
LymeNet Contributor
Member # 14002

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Originally posted on GS's Facebook book page....lyme literate nurse practitioner in SF. The local CBS affiliate news in San Francisco covered a story tonight on lyme disease and patients being denied treatment by insurance. In this story, Blue Cross.

The link to the video (with typed narrative)is:
http://sanfrancisco.cbslocal.com/2010/11/23/healthwatch-bay-area-lyme-disease-patient-fights-insurer/

My question is how many others on LymeNet are experience insurance denials for your treatment?

If so, this case could be a good reference for appeal for those with Blue Cross in CA.

I say this because the patient has appealed denials, and appears from this story to now have the backing support of the California Dept of Managed Care who has recommneded that Blue Cross pay the claims of this patient.

It would be great if those on this board who are so inclined could send positive acknowledgement to this newstation for the coverage of the story and to the staff person named as with CA Depart of Managed Care who has ruled/recommended in favor of the patient. Finally, the APPEARANCE of a victory.....stay tuned for Blue Cross' Response on tomorrow night's news broadcast.

Posts: 495 | From SF Bay area, CA | Registered: Dec 2007  |  IP: Logged | Report this post to a Moderator
ktkdommer
Frequent Contributor (1K+ posts)
Member # 29020

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I agree with you. I watched the news report as my sister is getting ready to start IV antibiotics and has BC/BS of AL. I saved it and sent her a copy.
I am fighting Aetna right now. Both companies have an extensive 12 page Lyme policy with all of the wrong research to support their no pay stance.
Do you have the ling for the insurance response? I only watched the first segment.

--------------------
Things are never dull. After 3 fighting Lyme, 2 are in remission. Youngest is still sick, age 22. He has new diagnosed Chiari Malformation and Ehlers Danlos Syndrome.

Posts: 1366 | From Perrysburg, Ohio | Registered: Nov 2010  |  IP: Logged | Report this post to a Moderator
Robin123
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Hi - this is a great news boost, with the program coming out twice in two days, the second one occurring at the dinner hour.

The second one did not have any insurance response. It had the usual statement from the other side about "there's no proof antibiotics work, where are the studies," which totally ignores clinical experience. I thought the first segment was the strongest.

The comments are strong, and I suggest more of us watch the segment and leave comments.

Any of us can contact Channel 5, by the way, and either chat with them about Lyme or leave a message. The phone number is 415-362-5550. The website address is http://sanfrancisco.cbslocal.com

Posts: 13171 | From San Francisco | Registered: May 2006  |  IP: Logged | Report this post to a Moderator
   

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