I’ve never dealt with anything like this before and I’m hoping someone can point me in the right direction. I’ll try to keep it brief while painting the full picture.
My 10 year old son is on my insurance and I have already hit our deductible for the year.
Recently my son was diagnosed with Crohns disease and his GI doctor put him on Remicade for a treatment.
His first Remicade treatment and lab work was at a hospital where his GI doctor works.
My insurance company then said we had to start going to a separate infusion center for future treatments. They sent us to a facility called Horizons Infusions.
Horizon sends out all lab work to LabCorp for processing.
So we did my sons second treatment at Horizons and they sent the lab work to Labcorp.
I recently received a bill from Labcorp for $280 because the insurance company denied one of the blood work tests. Specifically the test that monitors how much Remicade is in his system.
I contacted the insurance company and they said that the test is not approved because it was “investigational”. They said I should contact his doctor and have his doctor file an appeal or I could file an appeal but I would need documentation that the treatment is medically necessary.
So I contacted the hospitals billing department just looking for guidance but they said they couldn’t do anything.
Then I contacted the doctor who said that nothing they are doing is investigational and that we should contact the hospitals billing department…
I literally have no idea what I should be doing here or who I should be talking to and could really use some guidance.
$280 isn’t a lot of money for a once off but my sons treatments are every 2 months and if I have to pay it every time it will sting.
Please help!
submitted by /u/bFALSE
[link] [comments]I’ve never dealt with anything like this before and I’m hoping someone can point me in the right direction. I’ll try to keep it brief while painting the full picture. My 10 year old son is on my insurance and I have already hit our deductible for the year. Recently my son was diagnosed with Crohns disease and his GI doctor put him on Remicade for a treatment. His first Remicade treatment and lab work was at a hospital where his GI doctor works. My insurance company then said we had to start going to a separate infusion center for future treatments. They sent us to a facility called Horizons Infusions. Horizon sends out all lab work to LabCorp for processing. So we did my sons second treatment at Horizons and they sent the lab work to Labcorp. I recently received a bill from Labcorp for $280 because the insurance company denied one of the blood work tests. Specifically the test that monitors how much Remicade is in his system. I contacted the insurance company and they said that the test is not approved because it was “investigational”. They said I should contact his doctor and have his doctor file an appeal or I could file an appeal but I would need documentation that the treatment is medically necessary. So I contacted the hospitals billing department just looking for guidance but they said they couldn’t do anything. Then I contacted the doctor who said that nothing they are doing is investigational and that we should contact the hospitals billing department… I literally have no idea what I should be doing here or who I should be talking to and could really use some guidance. $280 isn’t a lot of money for a once off but my sons treatments are every 2 months and if I have to pay it every time it will sting. Please help! submitted by /u/bFALSE [link] [comments]Read Morer/HealthInsurance