Punch Biopsy & Insurance
 

Hello Everyone,

I just got the bill in the mail for my punch biopsy and it is pretty significant. My Horizion BlueCross BlueShield decided that the nerve analysis portion is experimental and will not pay for it. That portion of the test was $2000 all on its own. They did pay some towards the biopsy itself and the immunochemistry testing.

Has anyone run into this problem?

NO. Actually, Medicare didn't have a problem paying for either of my two biopsies...and Medicare can be very picky. You might want to check to see HOW they listed the necessity and what they put for the diagnostic code. It can make a difference how things get through the system.

My insurance didn't cover my biopsy either but the neuro would not schedule it in the first place until they had "insurance approval". I complained directly to the lab, explaining that I could not afford to pay it and they wrote it off.

Yes, Blue Cross is wonderful. They tell you that there is no pre-certification, and then cherry pick what is experimental. I am STILL grieving three claims for testing.

The biopsy is the gold standard and this is what Blue Cross Anthem (yes, my family's identification did get leaked) is still doing.

We already pay so much in premiums.

Hope you can find a way for maybe your provider to help.

Im sorry you have blue shield, i heard horror story about this insurance company, dropping people as soon they get a payment, doctors,ambulances mysteriously disappear from patient network