Question for Dr Johns patients
- 02-15-2007, 10:47 PM
- 02-18-2007, 12:30 AM
Seeing how no one has answered yet, I can provide some detail about my tests for a different doctor (in the interest of helping you get the answers you need as this type of treatment is important)
1. I am not Dr. John's patient but maybe I will be in the future.
2. For my doc, a full round of tests, drawn and tested at Lab-Corp ran about $1400. I think these are fewer tests than Dr. Johns, but included CBC, Lipids, Total T, Free T, E2, TSH, LH, FSH, PSA and maybe some more. The negotiated rate for my insurance came to be about $134. I paid 0. The docs put the correct "code" on the form and all my tests have been covered.
- 02-18-2007, 12:51 AM
02-18-2007, 02:02 AM
Could you explain how you got your insurance to cover all of that? I would appreciate any help in this matter. Thanks in advance!
02-18-2007, 02:10 AM
Below are those that I either use or consider or know about.
With those codes there is a good chance of insurance coverage.
I need them so I can give them to my doctor when he writes script for blood test.
Now I need good code when going for MRI and/or ultrasound of testicles, to check for varicocele and ohter stuff on my testicles.
ICD9Data.com - Free 2007 ICD-9-CM Medical Coding Database
257.2 Other testicular hypofunction 2007 ICD-9-CM Diagnosis 257.2 - Other Testicular Hypofunction
272.4 Other and unspecified hyperlipidemia 2007 ICD-9-CM Diagnosis 272.* - Disorders of lipoid metabolism
601.9 Prostatitis unspecified 2007 ICD-9-CM Diagnosis 601.* - Inflammatory diseases of prostate
780.4 Dizziness and giddiness 2007 ICD-9-CM Diagnosis 780.4 - Dizziness And Giddiness
780.79 Other malaise and fatigue 2007 ICD-9-CM Diagnosis 780.79 - Other Malaise And Fatigue
788.41 Urinary frequency 2007 ICD-9-CM Diagnosis 788.41 - Urinary Frequency
MESO-Rx - View Single Post - Adrenal fatigue, does it really exist?
255 Disorders of adrenal glands
For coding adrenal fatigue, I just use the code for Other Specified Disorders of the Adrenal Glands - which I call Adrenal Fatigue
255.8 Other specified disorders of adrenal glands 2007 ICD-9-CM Diagnosis 255.8 - Other Specified Disorders Of Adrenal Glands
HGH and Insurance Coverage
ICD-9 253.3 Adult Onset Growth Hormone Deficiency
02-18-2007, 02:17 AM
Just got this in an email
If you are paying out of pocket, we use the Rhein urinary panel to start, ($225) and add blood assays as needed. Cost for the bloodwork varies, but it is kept minimal, if needed at all. Kim
02-18-2007, 08:58 AM
02-18-2007, 12:10 PM
For me, it was really easy. I have Blue Cross/Blue Shield. I followed the instructions on forum.mesomorphosis.com on how to find a doctor. I found a list of doctors in my area and cross-referenced that with in-network providers from Premera BCBS and made an appointment.
The doctor's office wanted me to pay out of pocket for the first T test and phone consultation which was $95. They said if it was bad then later tests would be sent through the insurance. It turns out that they never charged me the $95 and they submitted that through the insurance also.
I asked the doctor's office admin person if it will all be covered and they said something to the effect of, "we hope so".
The way my blood tests work is that Lab-Corp is an in-network provider for testing and they happen to have a blood draw station 4 walking-minute away from my office. I have the doctor's office fax over of form with the tests they want (usually not as many as I want) a day or two before and then I go over to lab-corp, wait anywhere from 0 to 10 min, get my blood drawn and go back to work. The results are then sent to my doc in time for the next appointment. The insurance codes are on the faxed-over form, but I only briefly see it as I interrogate the plebotomist as to what is being drawn to make sure that at least the minimal is. Next time I will try to get them.
Now the slightly more complicated thing is that the dude I see, not the head doc, just can't get any blood test he wants. I wanted to get an IGF-1 and he thought for a second and said he could justify it. Based on that I think that they can't just request everything everytime but I am not sure.
I do not have the insurance codes available. They are normally on the form.
Having said all this, the company that I started with in July is a great company and I love working there. It is a dream come true for those of us who work in software, well most of them. This company has really great insurance. For example, some family had twins and these twins were born with some problem. The cost of delivery and related expenses was $500,000+ The familiy paid $0 out of pocket.
I am not sure what my doctor's office thinks of me. I think I scare them as I walk in with a whole binder full of urological articles, my own blood pressure tester, instructions on how I "think" I should be tested, treated and prescribed, etc.
02-18-2007, 12:33 PM
02-18-2007, 01:38 PM
I am insured by a staff model HMO that will not pay for for out-of-network treatment that they don't authorize, and it is extremely unlikley that they would authorize HRT.
I am fortunate to be able to pay out-of-pocket.
In the past, I have gotten my labs done through LEF. The labs for the initial workup cost me $750.00. If I had not gone through LEF, they would have cost over $1200.
However, as with many things, you get what you pay for. Going through LEF is pretty clumsy and the turnaround for results can be nearly a month.
Also, it seems that their customer service is really deteriorating. I have allowed my membership to expire and I am looking for a new source for discounted lab work, even if it costs a little more than LEF.
02-18-2007, 01:49 PM
If that's what it takes, then that's what it takes. I bring my internal medicine doc stacks of articles, and I have arguments all prepared in case he gives me trouble. So usually, a visit w/ him is more like a consultation instead of the usual 5-10 min. HMO doctor visit, where the doc stands at the examining room door with his hand on the doorknob.
It is unfortunate that you have to prepare for a doctor appointment like a lawyer preparing a closing statement, but that's the world of HMO medicine.
02-18-2007, 02:19 PM
02-18-2007, 02:35 PM
02-18-2007, 03:21 PM
02-18-2007, 05:18 PM
02-19-2007, 12:53 AM
02-20-2007, 12:20 PM
I have been a patient of Dr Johns for about 2
years now and used to have Medical Mutual of Ohio. They covered
everything 100% . I am now on Anthem BC/BS and they are
a pain in the royal (hine den). They argue about paying for
just about anything. Everything must be pre certified first. And
we supposedly have the "best PPO plan out there", figure
02-20-2007, 12:40 PM
02-20-2007, 12:46 PM
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