Un-freakin'-believable
 

I spent 14 months fighting my insurance to finally, FINALLY, get them to approve paying for the MuSK test. Fourteen months of back and forth and denials and appeals and begging doctors' offices to cooperate and assistance from my state Office of the Healthcare Advocate, to get them to approve that test, since it cost $1600-$1700 (depending on which lab it ran through), and I did not HAVE $1600 to pay for it if the insurance wouldn't.

So, I delayed getting the test for over a year while I fought it through the insurance. Finally won. Got the test done (and after all that, it was negative).

Just opened the EOB from my insurance. There is the charge, $1600, from the hospital lab that drew the blood and sent it out. And there is the "allowable charge" and amount paid by my insurance, paid in full, no charge or amount to me.

$23.89

How, why, I don't know. But my miserable (insert obscenities here) insurance held up my medical care for 14 months over their cost of only $23dollars and 89cents.

This should be criminal.

I understand your frustration over this situation. But many people deal with this same thing every day. Insurance companies will do anything they can to not pay for services, so this is nothing new. Have you asked for the LRP4 test? The same company does that as the MuSK.

The more important issue here is that you don't know what is wrong with you. I have no idea how to help you in that regard. I wish I did.

I hope you can find a way to put all of this behind you. Stress is not good for the body. Anger only hurts you. You deserve to be healed from all you have been through.

:grouphug:
Annie

Why do they fight so hard, over less than $24? They spent way more than that in all the administrative costs of fighting it.

And, it gets worse. Same envelope, EOB for horse's backside at Yale who stood there while his resident ran the EMG, the plain ol' ordinary EMG, not an SFEMG, and absolutely REFUSED to answer any questions or even offer advice on whether this was the end of the road for me with him, or if there was further avenues to pursue. Somehow, they charged for four separate items, and got paid $4,000 for it. They ran one test. Maybe the analyzed one test. How they came up with four large charges (totalling $5,000, but the insurance knocked it down to $4k) from running ONE test, I don't know. Might call their billing and ask for an itemized bill, to see if they charged for things they didn't run (wouldn't put it past him). Might not. Never going back there, anyway (there is so much more to it, that I didn't write out in the other posts, you just have to trust me. And my husband was there as witness and participant, so I know it's not just me/my perception, we are two very different people, so if we both see something the same way, that is how it was.)

Insurance refuses the LRP4 test based on CPT code. Have not begun the fight to get that one approved, don't have the strength, yet. Plus, I don't have a doctor for it, not using the Yale moron again, and my regular neurologist has never even heard of it, nor did she have any interest in finding out about it.

When I settle my insurance fight over my glaucoma surgery (they'd rather I go blind. Much cheaper for them that way.), then maybe I'll get into the LRP4 battle, and finding a new doctor to try.

Anyone know of a good place in New York City, or that area? Stamford Connecticut would be closer. New Jersey, farther.

Mostly, I give up. My ophthalmologist says he can prescribe the pyridostigmine now that others have, if they decide to stop. But he's 60 years old, so that will have a limited lifetime to it....