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dreamworld06
LIF Adult
Member since 2/07 1341 total posts
Name:
Heather
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Insurance company is denying bloodwork claim
I went for a physical at my primary care Dr and the insurance company denied some of the bloodwork saying it was not necessary in yearly bloodwork (for preventative care ). I'd like to appeal the decision and figured maybe someone on here would know the benefit of this bloodwork for preventive reasons. I figured it will give me more info to provide the insurance company. This is what was denied:
Vitamin d
Uric acid
gamma-glutamyl transpeptidase (GGT)
Folic acid
B12
Any info you can give me would be greatly appreciated!
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Posted 1/1/18 3:17 PM  |
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NervousNell
Just another chapter in life..
Member since 11/09 54921 total posts
Name:
..being a mommy and being a wife!
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Re: Insurance company is denying bloodwork claim
What was the reason you MD was testing you for those things?
I believe it would be your MD who could inform them of the necessities of those tests based on your medical history and/or concerns they had based on your exam, etc
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| Posted 1/1/18 3:46 PM |
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dreamworld06
LIF Adult
Member since 2/07 1341 total posts
Name:
Heather
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Re: Insurance company is denying bloodwork claim
Posted by NervousNell
What was the reason you MD was testing you for those things?
I believe it would be your MD who could inform them of the necessities of those tests based on your medical history and/or concerns they had based on your exam, etc
He didn't tell me he was doing something out of the ordinary. I guess I just assumed that's what he normally does for bloodwork. I guess I should give him a call.
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| Posted 1/1/18 4:21 PM |
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NervousNell
Just another chapter in life..
Member since 11/09 54921 total posts
Name:
..being a mommy and being a wife!
|
Re: Insurance company is denying bloodwork claim
Posted by dreamworld06
Posted by NervousNell
What was the reason you MD was testing you for those things?
I believe it would be your MD who could inform them of the necessities of those tests based on your medical history and/or concerns they had based on your exam, etc
He didn't tell me he was doing something out of the ordinary. I guess I just assumed that's what he normally does for bloodwork. I guess I should give him a call.
Yes they may have to resubmit the claim a different way.
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| Posted 1/1/18 4:38 PM |
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hope123
LIF Adult
Member since 2/08 1097 total posts
Name:
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Re: Insurance company is denying bloodwork claim
Posted by dreamworld06
I went for a physical at my primary care Dr and the insurance company denied some of the bloodwork saying it was not necessary in yearly bloodwork (for preventative care ). I'd like to appeal the decision and figured maybe someone on here would know the benefit of this bloodwork for preventive reasons. I figured it will give me more info to provide the insurance company. This is what was denied:
Vitamin d
Uric acid
gamma-glutamyl transpeptidase (GGT)
Folic acid
B12
Any info you can give me would be greatly appreciated!
Checking Vit D levels should be part of annual blood work especially in the winter. So many people I know have deficiency. I would call the doctor’s office and ask them to resubmit with a code that’s covered.
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| Posted 1/1/18 4:50 PM |
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pumpkinmom
LIF Adult
Member since 5/12 2912 total posts
Name:
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Insurance company is denying bloodwork claim
If you're looking for what should be covered at 100% as preventive, if you Google something like USPSTF A and B recommendations, you will find the list. It also has to be coded correctly by your doctor.
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| Posted 1/1/18 4:57 PM |
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NYCGirl80
I love my kiddies!
Member since 5/11 10413 total posts
Name:
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Re: Insurance company is denying bloodwork claim
It depends on your insurance company. I know some who deny Vitamin D, for example. My dr does it annually, but my sister usually has to pay OOP for it because her insurance doesn't cover it.
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| Posted 1/2/18 10:32 AM |
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