Jump to content

  • Welcome to Celiac.com!

    You have found your celiac tribe! Join us and ask questions in our forum, share your story, and connect with others.



  • Celiac.com Sponsor (A1):

    Celiac.com Sponsor (A1-M):

  • Get Celiac.com Updates:
    Support Our Content
    eNewsletter
    Donate

Insurance Coverage For Enterolabs

RunnerNYC

Recommended Posts

RunnerNYC Rookie
RunnerNYC
Posted

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?

Celiac.com Sponsor (A8):
Celiac.com Sponsor (A8):

Celiac.com Sponsor (A8-M):


mle-ii Explorer
mle-ii
Posted

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 Contributor
AndreaB
Posted

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

jerseyangel Proficient
jerseyangel
Posted

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

jams Explorer
jams
Posted

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 Contributor
Mayflowers
Posted
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 Rookie
chewymom
Posted

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.

Celiac.com Sponsor (A8):
Celiac.com Sponsor (A8):

Celiac.com Sponsor (A8-M):


RunnerNYC Rookie
RunnerNYC
Posted
  • Author

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 Contributor
AndreaB
Posted

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

Super Bellybutton Rookie
Super Bellybutton
Posted

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 Enthusiast
dionnek
Posted

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

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 Community Regular
penguin
Posted

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...

Archived

This topic is now archived and is closed to further replies.

Go to topic listing
  • Celiac.com Sponsor (A19):


  • Member Statistics

    • Total Members
      131,627
    • Most Online (within 30 mins)
      7,748
    kathrynhmarks
    Newest Member
    kathrynhmarks
    Joined
  • Celiac.com Sponsor (A20):

  • Forum Statistics

    • Total Topics
      121.4k
    • Total Posts
      1m
  • Celiac.com Sponsor (A22):



  • Celiac.com Sponsor (A21):


  • Upcoming Events

  • Posts

    • Inkie
      Thee

      By Inkie · Posted

      I  notice a reaction to tea bags, possibly due to gluten or other substances. Is this recognizable?
    • trents
      Taking Probiotics but Still Getting Sick After Gluten – Advice?

      By trents · Posted

      The blood tests you had done are not the main ones. The two main ones are the "Total IGA" (to check for IGA deficiency) and the "TTG-IGA". Current guidelines for the "gluten challenge" when people have been gluten free for a significant time period are the daily consumption of at least10g of gluten (about the amount in 4-6 slices of wheat bread) for at least two weeks leading up to the day of the blood draw. That should give you some perspective.
    • Xravith
      Taking Probiotics but Still Getting Sick After Gluten – Advice?

      By Xravith · Posted

      Thank you, really.  I took a test for DGP-IgA and DGP-IgG. Effectively, it is not enough to discard Celiac Disease. I was consuming gluten until then, I only started gluten-free some days ago, when the symptoms became horrible and now I feel considerably better, which is a second confirmation that gluten is the main problem. It's been more than 4 years I have the same suspect, when I first thought gluten was causing me problems, I made a gluten-free diet for a year, I felt really good as never before. However, neither I or my parents were well informed about Celiac disease, so none of us tried to make further exams. My father suffer digestive problems and other members of my family as well. Unfortunately, no one have ever been tested for Celiac disease. I'll have to restart eating gluten in the next weeks, so I can make a serious blood test in laboratory, hopefully between two or three months.
    • trents
      Taking Probiotics but Still Getting Sick After Gluten – Advice?

      By trents · Posted

      As Scott said, in order for celiac disease testing to be valid, you need to be eating generous amounts of gluten on a regular basis for weeks or months before the blood draw. The blood tests are designed to detect antibodies that the immune system produces in response to the ingestion of gluten. It takes time for them to build up in the blood to detectable levels.
    • Scott Adams
      Taking Probiotics but Still Getting Sick After Gluten – Advice?

      By Scott Adams · Posted

      Based on what you've described, it is absolutely crucial that you pursue further medical exams for Celiac Disease and related conditions with a gastroenterologist. Your symptoms—especially the worsening fatigue, loss of muscle mass, neurological symptoms like migraines, and palpitations, coupled with being underweight—are significant red flags that extend beyond typical IBS. The negative home test is not reliable, particularly given your concern about sample contamination and the fact that you were likely not consuming sufficient gluten at the time for the test to be accurate, which is a common issue. While probiotics like Bifidobacterium Infantis can support gut health, they cannot resolve an autoimmune response to gluten or heal intestinal damage caused by Celiac Disease. Your declining blood test results, even if still "in range," further indicate a trend that needs a doctor's investigation. Please do not hesitate to seek a specialist; a formal diagnosis is the first step toward getting the correct treatment, allowing your body to heal, and finally addressing your weight and overall health concerns. This article might be helpful. It breaks down each type of test, and what a positive results means in terms of the probability that you might have celiac disease. One test that always needs to be done is the IgA Levels/Deficiency Test (often called "Total IGA") because some people are naturally IGA deficient, and if this is the case, then certain blood tests for celiac disease might be false-negative, and other types of tests need to be done to make an accurate diagnosis. The article includes the "Mayo Clinic Protocol," which is the best overall protocol for results to be ~98% accurate.    
×
×
  • Create New...

Important Information

NOTICE: This site places This site places cookies on your device (Cookie settings). on your device. Continued use is acceptance of our Terms of Use, and Privacy Policy.