HGH and Insurance Coverage
- 12-13-2006, 06:18 PM
- 12-13-2006, 07:09 PM
12-14-2006, 07:24 PM
Dr John;Originally Posted by Dr. John
You must have had cases that were paid by insurace.
I assume that getting paid by insurance is in large measure a function of specific company.
What was your success with
Medicare and Blue Cross Blue Sheld?
The other reason for getting paid, may be a particular diagnosis and their related ICD-9 code.
Would you please help us here and post those ICD-9 codes that got paid.
12-14-2006, 09:41 PM
Originally Posted by Dr. John
I'd be willing to pay for the "negotiations" if I knew that, in the end, I would be covered. What is the required diagonosis to sustain coverage?
12-15-2006, 10:54 AM
I agree. I am actually quite dismayed at how much influence my employer has on what is covered. It really comes down to what they are willing to pay for their part of the premium. They try to cut their costs by cutting coverages off of a checklist. And of course these HR drones are hardly qualified when it comes to medicine.Originally Posted by JanSz
12-15-2006, 01:20 PM
We as patients and our doctors have to deal with reality as it is today.Originally Posted by wildfox
Our doctors by virtue of dealing with many situations may learn (if they are willing and have a time) what works and what not work in a way of getting reimbursment from insurance. With that knowledge they may, in some situations, decide on diagnosis (and ICD-9 code that goes with it) that have a higher probability of getting reimbursment.
I do not have a good example but I think this may help:
I am 66 yo, married and have all children I want, so getting HCG for my testosterone deficieny or ED (enter proper ICD-9 code) probably will not be covered by insurance. But I just recalled, I have a young girl on a side that I want to get pregnat, HCG will help me with fertility (enter proper ICD-9 diagnose code) also insurance probably would pay for this (diagnose).
Doctor knowing details may be helpfull if he presents options to the patient.
When I go to LabCorp to donate blood, there are flyers that explain why patients should make sure their doctors give them proper ICD-9 code, so they have a better probability of getting insurance to pay for the tests.
Insurance payment is often decided by doctors action or in action. Actually it does not have to be a doctor himself, I was able, one time, to straighten up some of my codes by sympatetic nurse at my doctors office. Properly trained nurse is a treasure.
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