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Old 11-30-2011, 01:07 AM #1
Liftyourhands7 Liftyourhands7 is offline
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Liftyourhands7 Liftyourhands7 is offline
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Default criteria for IVIG treatment

Today I read a letter from my insurance Company denying my doctors request request for IVIG, the insurance company stated I did not meet their criteria for IVIG, so I need help from all of you my friends here to fight this decision, however I don't really know where to start, this is exactly what the letter states thanks in advance for all of you reading this for it is quite long, " the documentation submitted indicates that the diagnosis was not confirmed by a neurologist via nerve conduction tests ( I did have this on both legs 2 times both test were negative) it continues to say, in addition the documentation submitted does not indicate the presence of motor or sensory dysfunction of more than 1 limb developing over at least 2 months ( I have since then had a skin biopsy that was positive for sfn) ,it continues to say areflexia (absence of neurologic reflexes), and a nerve biopsy showing clear evidence of nerve damage and repair(demyelination and remyelination) the subscribers plan does provide for standard services and medication. So to say the least I am a little discouraged, if I really need this treatment how in the heck am I going to be able to get it, my skin biopsy was positive for sfn, isn't that enough to re submit this? Will I need to hire an attorney to help me? Thanks in advance for all of you who take the time to read this. It's all so frustrating. for all of you who have been approved what did your Doctor do to get you approved. Thanks, Jan
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Old 11-30-2011, 08:52 PM #2
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They don't usually pay for IVIG for small fiber neuropathy unless an inflammatory component is involved, such as, perhaps, if your ANA is elevated. Mine was prescribed because they thought it was inflammatory, still may be...that said, after a few years, IVIG didn't help my in case. That is not to say it won't in yours. I guess you need to file a formal appeal and reject their premise. Can your doc help?

I have a friend who is literally going to die if she doesn't get Remicade for her Sarc, and the insurance rejected that! Insurers are not exactly benevolent.

Just make sure you file your appeal in their time limits.
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