Insurance denied hepatitis test req'd by RE--How to get it covered? - Mothering Forums

Forum Jump: 
 
Thread Tools
Old 07-23-2011, 03:26 PM - Thread Starter
 
lkmiscnet's Avatar
 
Join Date: Jan 2009
Location: Colorado
Posts: 420
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
The hep test was part of all the bloodwork required by my fertility clinic before proceeding with our FET.

Apparently, it is not covered when coded under a diagnostic infertility code, as it does not cause infertility. Both my husband and I had to have the tests, which cost almost $500!

Anyone get that test covered and can you tell me how your clinic got it covered? What code did they use? I think the codes are universal. They should be able to re-code it and  re-submit it.
 
I'm guessing that if my regular primary care physician had ordered the hep test as part of a normal exam, it would have been covered, so not sure how a fertility clinic would need to code it. Maybe I would have needed to have shown "symptoms" to justify the test...

Thanks.

lkmiscnet is offline  
Sponsored Links
Advertisement
 
Old 08-11-2011, 12:25 AM
 
cheerma's Avatar
 
Join Date: Nov 2007
Location: California
Posts: 70
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
I'm a wahm for an insurance company. Have your doc resubmit the claim with any dx you have that is the confirmed/possible underlying medical cause of your infertility. Many plans cover the cost to treat and test for the underlying medical reasons. They won't deny treatment that is medical. Maybe you have pain during menses or irregular cycles. Just any other medical dx should work. Even women who aren't ttc would want their pain or possible medical conditions treated. PM me if you need more info.

Married 2002. Adopted 1 DD. Planning in vitro for 2012 due to low egg reserve.
Me 30 WAHM, DH 58 SAHD (5 adult children from ex #1).
DD dob 5/13/07 came home 2007, 5 months old via foster care. Adopted 2009, almost 3 years old.
DD is high functioning autistic. She keeps us laughing and exhausted!
cheerma is offline  
 
User Tag List

Thread Tools


Forum Jump: 

Posting Rules  
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are On
Pingbacks are On
Refbacks are Off