Guest guest Posted February 14, 2009 Report Share Posted February 14, 2009 Some people have had problems getting their insurance company to pay for genetic testing. Here are some suggestions: 1. Most commercial insurance policies will only pay for the test if the medical records indicate the presence of CMT symptoms prior to the test being performed. In other words, if you are being tested because another family member has been diagnosed and you want to know if you have it, the insurance company will probably not pay for it. So be sure your medical records indicate the medical necessity for the test, i.e. the presence of CMT-like symptoms and all relevant clinical findings. Also, make sure the doctor puts the appropriate clinical diagnostic code on the requisition form when ordering the test. 2. You can utilize Athena Diagnostics for the test and sign up for their " Access Athena " program at the time the test is being ordered. If your insurance company doesn't contract with them and doesn't pay for the full amount of the test, Athena will limit your liability to 20% of the cost. The program doesn't apply in all locations or situations, but it could help some people. Contact them directly for details. http://www.athenadiagnostics.com/content/ordering/billing http://www.athenadiagnostics.com/content/ordering/access-athena 3. Contact your insurance company and the testing lab prior to having the test performed, to make sure you've fulfilled all protocol obligations and you are utilizing the appropriate provider. 4. If you have the test performed and payment is denied by the insurance company, post to the group for assistance, while you still have time to appeal. Quote Link to comment Share on other sites More sharing options...
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