RE: Insurance Coverage of in-home high dose steroids

[Guest guest]

That’s

interesting, I am on a new insurance with my husband, but the old one paid and I

just went to an outpatient center and they started the IV and gave me the drugs

to administer at home, it was easy and they paid like 80/20. this last time on

this current insurance they paid, but there provider was from a major city I live

in a small city in No. Colorado, so they had a home health nurse come to the

house and start the IV then a courier brought me the drugs, and I had to pay

again the 20%, but I had to pay before they would live the medication, COD. I would

think either one should pay, you just may have to jump through some hoops

first, always seems that way, good luck. Marla

From: Neurosarcoidosis [mailto:Neurosarcoidosis ] On Behalf Of EbonyWreh

Sent: Wednesday, October 24, 2007

1:11 PM

To: Neurosarcoidosis

Subject:

Insurance Coverage of in-home high dose steroids

Hey everyone,

's neuro decided to but him on a 3 day of solumedrol to see if it

helps his possible flare up. The nurse called me and told me that his

medicare hmo doesn't cover it and his medicaid probably won't either.

So, this leads me to wonder. Do your insurance companies cover the

infusions? I remember that the last time he had it done and he just

had regular medicare we went through a similar issue with billing, but

I can't remember how we resolved it. If we paid out of pocket or

somehow got it covered. I really feel like insurance companies should

be paying more, but when I see how much they pay already, it is hard

to say that.

[Guest guest]

That’s

interesting, I am on a new insurance with my husband, but the old one paid and I

just went to an outpatient center and they started the IV and gave me the drugs

to administer at home, it was easy and they paid like 80/20. this last time on

this current insurance they paid, but there provider was from a major city I live

in a small city in No. Colorado, so they had a home health nurse come to the

house and start the IV then a courier brought me the drugs, and I had to pay

again the 20%, but I had to pay before they would live the medication, COD. I would

think either one should pay, you just may have to jump through some hoops

first, always seems that way, good luck. Marla

From: Neurosarcoidosis [mailto:Neurosarcoidosis ] On Behalf Of EbonyWreh

Sent: Wednesday, October 24, 2007

1:11 PM

To: Neurosarcoidosis

Subject:

Insurance Coverage of in-home high dose steroids

Hey everyone,

's neuro decided to but him on a 3 day of solumedrol to see if it

helps his possible flare up. The nurse called me and told me that his

medicare hmo doesn't cover it and his medicaid probably won't either.

So, this leads me to wonder. Do your insurance companies cover the

infusions? I remember that the last time he had it done and he just

had regular medicare we went through a similar issue with billing, but

I can't remember how we resolved it. If we paid out of pocket or

somehow got it covered. I really feel like insurance companies should

be paying more, but when I see how much they pay already, it is hard

to say that.

[Guest guest]

Ebony, I can't imagine why they wouldn't cover it, unless it's the way it's coded. Most hospital & office insurance people know how to code meds & procedures so that they will be covered, without risking being charged with fraud. Just as insurance companies will sometimes cover Remicade for "rheumatoid arthritis" or "sarcoid-induced arthritis" while declining coverage for NS, your doctor may need to use a different diagnostic code. Call the office & talk to the insurance person to see how they are coding it.

Ramblin' RoseModerator A merry heart is good medicine. Proverbs 17:22Help yourself to FREE treats served up daily at the Messenger Café. Stop by today!

[Guest guest]

Ebony, I can't imagine why they wouldn't cover it, unless it's the way it's coded. Most hospital & office insurance people know how to code meds & procedures so that they will be covered, without risking being charged with fraud. Just as insurance companies will sometimes cover Remicade for "rheumatoid arthritis" or "sarcoid-induced arthritis" while declining coverage for NS, your doctor may need to use a different diagnostic code. Call the office & talk to the insurance person to see how they are coding it.

Ramblin' RoseModerator A merry heart is good medicine. Proverbs 17:22Help yourself to FREE treats served up daily at the Messenger Café. Stop by today!