Insurance Coverage For Enterolabs

[RunnerNYC]

Just wanted to know of those who got the enterolab tests done - who was able to get their insurance to reimburse the tests...?

Does anyone know how I can get my insurance to cover it?

[mle-ii]

Don't know if mine would have been covered but I'll check when I can.

Here are the numbers for your insurance company from my invoice.

One Gluten and Milk sensitiity stool/gene panel complete ($369)

Itemized costs of Stool tests included in panel

Antigliadin IgA (CPT 83520) $99.00

Anti-tissue transglutaminase IgA (CPT 83520) $50.00

Anti-Casein IgA (CPT 83520) FREE

Quantitative fecal fat (CPT 82710) $90.00

Itemized Costs of Gene Tests included in panel

HLA-DQB1 typing:

PCR Amplification (CPT 83898) $30.00

DNA Isolation (CPT 83890) $30.00

DNA Separation (CPT 83894) $30.00

Probe Identification (CPT 83896) $30.00

Molecular Identification and Interpretation (CPT 83912) $10.00

One Egg, Yeast and Soy Sensitivity Stool Panel ($199.00)

Itemized Coslts of Stool Tests Included in Panel

Anti-Saccharomyces cerevisiae IgA (CPT 83520) $66.33

Anti-Ovalbumin IgA (CPT 83520) $66.33

Anti Soy IgA (CPT 83520) $66.33

Materials and shipping charge $19.95

Total charge: 587.95

[AndreaB]

I didn't even try to run it through insurance. Sorry I can't help you.

[jerseyangel]

My insurance company told me that they would cover any testing ordered by my doctor.

[jams]

I just had my kids HLA tested through the dr. My insurance paid th 90% they should have. My dr was little worried that they might not cover, but they did. It was $297 per kid (2kids) and I have to pay $25.82. They sent it to Quest in Chicago.

[Mayflowers]

Just wanted to know of those who got the enterolab tests done - who was able to get their insurance to reimburse the tests...?

Does anyone know how I can get my insurance to cover it?

I submitted mine to NJ Plus (Blue Cross Horizon) and I'm still waiting for a response. I called and they said I have a $100 deductable and then 70% will be reimbursed....It's been a couple of weeks.

[chewymom]

I have Blue Cross Blue Shield of Alabama. My daughter's was covered, but I was not reimbursed the full cost. Enterolab was considered out of network, so first they took off the $200 deductable. Then they paid 50% of all other "customary" charges--meaning they considered some of the costs to be too high. Basically, they paid about $60 for her. I have already met my deductable, so if I get tested, they'll reimburse about $150 of the $360 I pay.

[RunnerNYC]

Thanks guys. I also have empire blue cross blue shield HMO. They basically told me enterolab is out of network, but that they would pay for any lab tests done at quest diagnostics. from what i can tell quest does the gene test, but i don't really understand how that is different from enterolabs...

[AndreaB]

Enterolab also tests stool for gluten/dairy/soy/egg/yeast antibodies....depending on what all you order.

[Super Bellybutton]

If the tests are done at Quest or LabCorp, my insurance covers it (Alliance PPO).

Other than that I doubt the Enterolab would cover it.

[dionnek]

I was told that mine would be covered 100% (by BCBS of GA) - I met my deductible a LONG TIME AGO

Anyway, I just did the genetic test on my daughter with Enterolab since I was dx by blood test and biopsy 3 months ago. Just sent in the claim, so not sure yet if they will really pay (lady on the phone at BCBS said it was covered). We'll see.

[penguin]

I imagine, though I haven't checked with my company (United), that you'll have a much better chance of having it covered by a PPO than an HMO...