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BRAF gentiec testing
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BRAF gentiec testing

› Forums › General Melanoma Community › BRAF gentiec testing

  • Post
    • October 17, 2017 at 7:41 pm
    SDFun
    Participant

      Hi

       

      I just got a voice my from teh billign depatment at the hospital my onoclogist is at that implies that insucne will not cover this testing and it may be $5000. I was wonderign what other people have learned? Did you have the testing and if so did your insuance cover all or a portion of it

       

      Thank you

       

      Nancy

    Viewing 4 reply threads
    • Replies
        • October 17, 2017 at 8:33 pm
        youngann
        Participant

          Hi Nancy. I had no idea that BRAF testing was being done on my tumor until I received a bill for $38,000. I also received a letter stating that, since my insurance wouldn't cover it, I was responsible for the whole amount.

          My advice is to have your doctor call your insurance and explain that this is a much needed test – see if that helps.

          Good luck,

          Ann

          • October 17, 2017 at 10:28 pm
          J.bun
          Participant

            I know every insurance plan is different, but so much in the medical care system comes down to diagnostic codes – and those codes can deem if insurance approves or not. Perhaps you can find out more from insurance, but many office staff are familiar with this and perhaps can update and resubmit the bill/claim?

            I just went through this with my surgery (20k+) and it was a clerical error. 

            • October 17, 2017 at 10:28 pm
            J.bun
            Participant

              I know every insurance plan is different, but so much in the medical care system comes down to diagnostic codes – and those codes can deem if insurance approves or not. Perhaps you can find out more from insurance, but many office staff are familiar with this and perhaps can update and resubmit the bill/claim?

              I just went through this with my surgery (20k+) and it was a clerical error. 

                • October 18, 2017 at 12:14 am
                Toby0987
                Participant

                  Just a thought-do you really need to get it done? I don't think it is necessary if you are not going to take certain pharmaceuticals. That is:  you may not need the genetic test if the treatment doesn't depend on whether you are BRAF pos or not. If the treatment does depend on your genetic test then it would be worth to have the onc type/dictate a short memo explaining that. 

                • October 18, 2017 at 12:56 am
                TexMelanomex
                Participant

                  Mine was covered in full by insurance (United Healthcare), and I also did not know it was happening until I saw the test results. I think I might try to make the argument with the hospital and insurance company to play with the billing and procedure (CPT) codes and see if they can get the insurance to cover it or cover most of it. You may never need it, but if you do need the information I'd hate to be staring down that bill also. Just my two cents worth.

                  Tex

                  • October 18, 2017 at 4:46 am
                  MovingOn
                  Participant

                    I had something similar happen. There was a mistake in the way it was billed to insurance. Instead of resubmitting it to insurance the genetics testing company sent me a bill saying “insurance has paid what they are going to and you are responsible for _____$”

                    I then called insurance and they gave me the details to provide to the genetics testing company.

                      • October 18, 2017 at 2:35 pm
                      SDFun
                      Participant

                        Thank you al. the Billing cleric said she would work with me and my doctor. i need teh testing becasue teh only treatment i can take right now is teh one for the VRAF tumers becasue i have chronos. We decied that we may need to resubmit with an explainition but review precudreis prety qucik and the hosptial said they will wait while it is under review is necessary

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