Igenex test-UHC Insurance

[Healingthedude]

Hi, We have United Health Care Insurance. (Choice Plus)

 

Has anyone been reimbursed for Igenex testing?

 

How much of the 600-800 did you get back?

We have met all our deductables for 2010,

so I am debating if I should take my son in the next few days for this.

 

thanks for any input.

 

Carolyn

[MichaelTampa]

I have Aetna, not UHC. My plan paid 70% of what they considered reasonable charges, because it considered IGeneX out of network. They ended up paying for about 50% of it.

[Suzan]

I have UHC and was paid 80% back of our $200 bill for each of us.

 

s

[sf_mom]

We have Blue Shield of CA and got back about 50% of cost. We did full panel plus co-infections initially. I wish we had only done basic Western Blot via Igenex prior to seeing an LLMD. It turned out two of our three children needed additional provocation testing and only one child has strong antibody response. Therefore other forms off testing were required to determine the presence of Lyme and co-infections via several different labs.

[philamom]

We received 70% back from Aetna.

[NancyD]

We have Harvard Pilgrim Health and got back 80%.

[justinekno]

Did you have any problems with aetna paying for both Igg and igm? I even resubmitted with modifier code and they still would only pay for igg and not igm.

 

We received 70% back from Aetna.

[philamom]

Did you have any problems with aetna paying for both Igg and igm? I even resubmitted with modifier code and they still would only pay for igg and not igm.

 

We received 70% back from Aetna.

Yes, after many calls explaining to them that if was two distinct tests, they covered. We had the Igenex testing done on my dd in July, and again in Sept, and on myself in November.

[justinekno]

Did you have to appeal or just make many many calls? Do you by any chance still have your explanation of benefits to see what coding they used? Aetna read me their procedure for when a modifier code is used and it basically tells them to revert back to the procedure they use when the same service is done twice which is to only reimburse for one. Drives me crazy!

 

Did you have any problems with aetna paying for both Igg and igm? I even resubmitted with modifier code and they still would only pay for igg and not igm.

 

We received 70% back from Aetna.

Yes, after many calls explaining to them that if was two distinct tests, they covered. We had the Igenex testing done on my dd in July, and again in Sept, and on myself in November.

[philamom]

Did you have to appeal or just make many many calls? Do you by any chance still have your explanation of benefits to see what coding they used? Aetna read me their procedure for when a modifier code is used and it basically tells them to revert back to the procedure they use when the same service is done twice which is to only reimburse for one. Drives me crazy!

 

Did you have any problems with aetna paying for both Igg and igm? I even resubmitted with modifier code and they still would only pay for igg and not igm.

 

We received 70% back from Aetna.

Yes, after many calls explaining to them that if was two distinct tests, they covered. We had the Igenex testing done on my dd in July, and again in Sept, and on myself in November.

No appeals...just many calls. I'll pull out my bill's and pm you over the weekend.

[GraceUnderPressure]

Totally ignorant question here - how do I submit our Igenex bills to our insurance (also UHC Choice Plus) for reimbursement?

Edited January 26, 2011 by GraceUnderPressure