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» LymeNet Flash » Questions and Discussion » Medical Questions » IV denied, need the latest ammunition PLEASE

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Author Topic: IV denied, need the latest ammunition PLEASE
Fordace
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Hi Guys,

My insurance has denied my IV treatment.
Does anyone who can think clearly have the latest and the greatest appeal procedures?

I have looked at links until I'm blue in the face.
My Lyme brain is going to burst [bonk]

Please let me know, thanks to ALL....Rich

Posts: 208 | From Hudson Valley, New York | Registered: Mar 2008  |  IP: Logged | Report this post to a Moderator
feelfit
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Anyone have any help for Rich?
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fatigued15
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sent a PM
Posts: 488 | From NY | Registered: Oct 2004  |  IP: Logged | Report this post to a Moderator
Fordace
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keep them coming THANK YOU.....Rich
Posts: 208 | From Hudson Valley, New York | Registered: Mar 2008  |  IP: Logged | Report this post to a Moderator
stymielymie
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could try oral vantin
it is generic and equivalent or iv rocephin
high dose may be needed to get therapeutic level

docdave

Posts: 1820 | From Boone and Southport, NC | Registered: Sep 2006  |  IP: Logged | Report this post to a Moderator
bettyg
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go to top of medical to my NEWBIE'S PACKAGE LINK, and read table of contents


TIMACA has great info there. copy what it says and then do a EDIT, FIND, and PASTE that name in so it takes you directly to timaca's effective link of action!


you must have copied ALL of my package to ms word PRIOR!!

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Fordace
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To the top
Posts: 208 | From Hudson Valley, New York | Registered: Mar 2008  |  IP: Logged | Report this post to a Moderator
KS
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Why were you denied treatment? did you test positive for lyme?
Posts: 561 | From mass | Registered: Jul 2007  |  IP: Logged | Report this post to a Moderator
Munch
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You may want to file a complaint with your state's office of professional responsibility (insurance regulation type office -- don't know what NY calls it's office). When I do this in IL, I get a reply from my insurance company within 5 days instead of 5 weeks.

You should get a copy of your policy and find out under what conditions they will pay. This is how I got approval for HGH. They sent a 27 page decision tree. Then of course, you have to go about meeting their conditions.

PS: Ask your doctors & insurance company if they'd like to be in Michael Moore's next movie. Get your own health care card here:

http://www.michaelmoore.com/sicko/what-can-i-do/health-card/

[ 14. January 2009, 07:49 PM: Message edited by: Munch ]

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Fordace
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quote:
Originally posted by KS:
Why were you denied treatment? did you test positive for lyme?

They said IV Rocephin was not proven to help eradicate my disease. It certainly helped my for about 7 months, all summer I felt fairly good after 8 weeks Rocephin. But, now, all major symptoms are coming back with a vengence, especially the neuro, anxiety and heart stuff...Rich
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Munch
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When they want to find Bb in ticks they use the right RNA primers. When they test people, like they did in the Abx studies, they used different primers. Say what?
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KS
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One thought would be to get tested again and to see if you turn up positive again (IgM that is). You could claim 'new infection' and they might cover....

You'll get better advice from others here regarding long-term IV treatment...

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Amanda
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The California Lyme Disease Association has created a form letter for insurance denials. you can download it, and then add your contact and other personal information.

IT was written by an legal expert with experience in insurance denials for lyme.

And it applies to anyone in the US, not just CA. Good luck, thte link is below

http://www.lymedisease.org/resources/insurance.html

--------------------
"few things are harder to put up with than the annoyance of a good example" - Mark Twain

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