View Single Post
Old 09-12-2007, 10:51 AM
pono pono is offline
Member
 
Join Date: May 2007
Posts: 270
15 yr Member
pono pono is offline
Member
 
Join Date: May 2007
Posts: 270
15 yr Member
Default IVIG issues

thanks all for support, info....
I did email igliving.com advocate and hope will get call or some advice.

I just spoke w/ neuro's office; as he prescribes IVIG often, he has one person who handles this. I updated Missy on what transpired w/ Medicare who filed a complaint on my behalf w/ Humana, that generated a phone call w/in day from insurance co.
That Rep. went thru all the old reasons for denial then after being on hold awhile came back on, to tell me reason for denial , per review May 2007 was that IVIG is not FDA approved for my condition -CIDP.
as I expressed before, I thought it was, but some research seems to show it's not.....

Missy said that DX: CIDP has been used for other patients and insurance approved. She couldn't remember if Humana was one of the Co's but she said she will resubmit appeal and get back to me.
we discussed pro/cons of changing insurance providor now; she feels at this point may be better to wait & see what Humana does, than start from scratch w/ a new insurance co, and go thru the same --approval/denial/ apeal game....

DR. B , my neuro, feels IVIG is THE treatment and is indicated for my condition. that should be enough but isn't.... DRs/ offices get jammed up dealing w/ insurance issues ... no wonder we, as patients don't get what we need or deserve....

I wonder how many Drs, medical professionals are on these Review boards or if it's businessmen making decisions to save or make $$$$.

This process of denial, appeal, denial, appeal reminds me of the social security disability process..... that's how it went till I went before a judge & was finally approved for Disablity years ago.

Perhaps persistance will pay off in this issue too... and get approval to resume IVIG...

again, thanks to all, for your input, support and help....
pono is offline   Reply With QuoteReply With Quote