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Crohn's Disease Forum » Your Story » New to the forum - Hey everyone!


09-20-2017, 12:28 PM   #1
rkunz2
 
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Join Date: Sep 2017
Location: Mesa, Arizona
New to the forum - Hey everyone!

In 2007, I was diagnosed with Spastic Colon. I had no idea that was related or in the family of IBS until just a few years ago. Over the last decade, my IBS morphed to IBS-D and then in 2016, I was diagnosed with Crohn's. Likely had Crohn's long before 2016 but ignored systems (typical guy) because in 2015, my wife was diagnosed with the rarest form of breast cancer, so I became a caregiver.

Now, like many of you, our health insurance (BCBS of South Dakota) is denying claims for fecal Calprotectin and a Humira anti-body level test done by Prometheus Labs. Calprotectin came in at 367 and anti-bodies showed negative, so the frequency of Humira treatments were increased to weekly. However, my stress levels are through the roof because I now find myself being stuck with an additional $2,800 in labs bills because BCBS is armchair diagnosing me, stating the tests are experimental and investigational, just like many of you. Really?

Anyway, my doctor suggested, a while back actually, that I join CCFA because it's a wonderful resource. So, hey there everyone!
09-20-2017, 01:07 PM   #2
Magnolia24
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Join Date: Nov 2013
Location: Oregon

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I've had insurance initially deny coverage for lab tests but say that my doctor could fax a letter explaining why it was medically necessary. Is that an option you've tried?
09-21-2017, 06:00 PM   #3
dave13
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Location: Maine

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Welcome to the Forum. Sorry to hear about your insurance issues. It is something many of us share here in the good 'ol U,S of A. Do you have a good rapport with your doctor? Having a doctor call the insurance company and explain why a test is needed before it is done may help. Not always,but it is worth a try. This information does not help now,I know. Perhaps it may help in the future.

Is your doctor associated with a hospital? If so,there is a thing called good faith payments. You acknowledge your bill and pay what you can a month. I am doing that now. Perhaps it varies from state to state. I have bills from previous surgeries gone to collection agencies. I was surprised they were easier to deal with than the hospitals. Haha. I was able to come to a mutual agreement and I pay that amount each month.

Good luck to you.
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