LymeNet Flash: Has Medicare stopped covering costs of Igenex tests?

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»	LymeNet Flash » Questions and Discussion » Medical Questions » Has Medicare stopped covering costs of Igenex tests?

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Author

Topic: Has Medicare stopped covering costs of Igenex tests?

tickedntx
LymeNet Contributor
Member # 5660

posted

Medicare is refusing to cover costs of Igenex testing for a friend. I thought they used to cover all costs. They did when my parents were tested last fall. There is, or at least was, a section on the lab order to fill out with Medicare information so that the patient would not have to pay up front and then seek reimbursement.

Has this changed? Is there a new procedure for obtaining reimbursement?

TIA to anyone who can help.

Suzanne

Posts: 977 | From Austin, TX, USA | Registered: May 2004 | IP: Logged |

nan
Frequent Contributor (1K+ posts)
Member # 63

posted

Hi Suzanne,

I had someone tell me recently that Medicare did not cover testing at IgeneX!
I could not believe it, because several months ago I had a test for Ehrlichia there and it was covered by medicare.

Try their website and call the 800 number
and ask them if medicare routinely covers their testing. http://www.igenex.com/index.shtml

If you find out, would you post it for us since many of us would be affected?

Thanx....nan

Posts: 2135 | From Tick Country | Registered: Oct 2000 | IP: Logged |

trueblue
Frequent Contributor (1K+ posts)
Member # 7348

posted

Yipes! I don't know either Suzanne but I had tests run mid June. The form still had the medicare box on it. (That doesn't mean they'll pay it though.)

They were covered in the past. I haven't recieved a medicare summary on the new ones, yet.

Posts: 3783 | From somewhere other than here | Registered: May 2005 | IP: Logged |

tabbytamer
Frequent Contributor (1K+ posts)
Member # 3159

posted

I just had tests run two weeks ago. And they still had a place on the form for direct Medicare billing.

I hope they are still doing it, otherwise I'll be hit with a lab bill I have no way to pay
tickedintx: Could it be that maybe your friend's doctor did not support requesting the lab with appropriate diagnosis codes?

Or maybe they forgot to include a photocopy of your friend's Medicare card when they sent off the kit?

------------------
Tabby

[This message has been edited by tabbytamer (edited 24 July 2005).]

Posts: 2098 | From San Diego, CA, USA | Registered: Sep 2002 | IP: Logged |

tickedntx
LymeNet Contributor
Member # 5660

posted

Tabby:

Excellent questions, and I will forward them to my friend.

Thank you to everyone who has replied.

Posts: 977 | From Austin, TX, USA | Registered: May 2004 | IP: Logged |

deja vu
Member
Member # 7656

posted

I just had labwork done with Igenex last week and spoke with them on the phone. I believe it is still covered....section for Medicare which they also mentioned over the phone. So should be OK.

Posts: 14 | From Bergen County, NJ | Registered: Jul 2005 | IP: Logged |

perplexed
LymeNet Contributor
Member # 1913

posted

I sure hope they still use Medicare. I have an appt with an LLMD in a few weeks, and he uses them. I will be up a creek paddling backwards if they do not!!

Jean :

Posts: 324 | From Lexington, KY, USA | Registered: Dec 2001 | IP: Logged |

nannie
LymeNet Contributor
Member # 5250

posted

In our state, we have this wonderful little consumer law that puts the burden of finding out what and what amount insurance will cover on the treating healthcare provider. Failure to advocate, no matter what state you are in and no matter if you participate can cost a healthcare provider their license-and it will be forwarded to the appropriate state.

WRT Igenex. Medicare bills are overseen and processed by fiscal intermediaries (FIs). FI's acceptance and reimbursement amounts can vary according to the FI. So if you have Medicare, an Igenex test might be covered under Medicare in one state but not covered in another state depending on the FI. Reimbursement amounts would also vary.

I have not checked the Igenex form of late, but, always check all medical forms for lines/provisions thta make you financially liable. Cross them out. If anyone says anything, tell them that they violate participating provider contracts-i.e. in the case of Medicare, could trigger an investigation. See how fast this gets your bills paid in full.

Posts: 183 | From US | Registered: Feb 2004 | IP: Logged |

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