Celiac Panel Bloodwork

[njbeachbum]

OK so I had blood drawn to test for Celiac on November 9, 2007. My Insuance provider is Aetna. When they received the claim from Quest Diagnostics, they denied all 3 tests for the Celiac panel on the basis that they are "experimental and investigational". I am now slapped with a bill for $600 that is ready to go to a collections agency and I am fighting with Aetna reps, Quest reps and my doctor's office to appeal this and get it paid for. Even according to my doctor, there is nothing experimental about these DIAGNOSTIC tests.

This is so frustrating! I'm wondering if anyone else has had a similar battle with insurance over this blood work.

[Gemini]

OK so I had blood drawn to test for Celiac on November 9, 2007. My Insuance provider is Aetna. When they received the claim from Quest Diagnostics, they denied all 3 tests for the Celiac panel on the basis that they are "experimental and investigational". I am now slapped with a bill for $600 that is ready to go to a collections agency and I am fighting with Aetna reps, Quest reps and my doctor's office to appeal this and get it paid for. Even according to my doctor, there is nothing experimental about these DIAGNOSTIC tests.

This is so frustrating! I'm wondering if anyone else has had a similar battle with insurance over this blood work.

To be honest, I paid for my testing out of pocket because I wanted it done FAST and the doctor I went to was not covered under my HMO plan. This is a precursor to national health and what we are in for if certain people are elected to office in this country.

Mine was done 3 years ago and I paid $380.00 for a full Celiac panel. So, I really do not understand why your cost was so high. Secondly, your doctor's office should be handling this for you, if they filed the original claim. If your doctor ordered the panel, they should cover it, period. I would think a short call from the physician to the crooks at the insurance would do it but I know that's a tall order for some doctors to do.

If the claim is in dispute, then you are not obligated to pay it, no matter what a collection agency might say in the near future. Seeing's as this country lets illegals flood our emergency rooms for free medical care, I would not give in and pay it! In fact, if you receive any threatening calls, I would ask them point blank if they harass illegals as much as citizens for payment...that usually shuts them up!

[njbeachbum]

lol - thanks, i needed that. the problem is that my doctor's office called a couple of weeks ago and told me that everything was taken care of. then the collection notice arrived the other day. so i called aetna, and spoke with a complete moron who said i have to file an appeal. apparently nobody told my doctor's rep that when she called two weeks ago. what a cluster f@ck. so then i hung up at 4:45 and called my doctors office (hours till 5pm) and i got their answering service. how nice. i wish i could leave work early everyday too.

ok. end of rant.

[happygirl]

They are NOT investigational at all----you are right.

Good luck! Hopefully your doctor will be able to clear this up.