This Is MS Multiple Sclerosis Community: Knowledge & Support

Hello everyone! I am having angio by dr sclafani next week and have been working on insurrance. I would be happy to help those in need from usa > I have personal experience with referals preauthorization and codes especially for horizon blue cross blue shield(NY is empire PA keystone nj horizon) and also disability. It is very important to get all set up in advance so they pay! I would be happy to help anyone I can and the more info I get I will post and try to help. Barbara PS it's a mass of BS my frienDs but the more info you get get the easier it is!

Hi Barbara,

I would love to hear the details about this.

Did you need a referral to Dr. Sclafani, or were you able to self-refer?

What were the codes used to get pre-approval for the tests?

Did you work with the insurance company direclty, or did someone from Dr. Sclafani's office help with that?

I'm working with a local IR in my area and think I can get the testing done if I can sort out the insurance issues.

Thanks!
Pam

Hi Barbara -
I too would be interested in the codes for insurance purposes. I have a venogram scheduled for April 2nd and my doctor felt as if my insurance would not pay since it is not a tested procedure for MS. Any information you have would be great!
Thanks!

use dx code 747.81. congenital abnormalitties vascular system. If you tell me what state and type insurance you have i can give you other suggestions. barbara

I am in SC and use Blue Cross/Blue Shield insurance. Do I need a another doctor to refer me?

Who are you going to liberate with? Where? I had bc/bs insurrance I paid for and didnot need referral. Bcross bshield medicare you do. Send me info. Do you have a primary doc you must go to first.? First time I had doppler and mrv done vascular surgeon used code fo jugular stenosis worked fine to. Unfortunately the mrv was not done all that well per protocal. Venogram are the best test if they know what to look for. barbara

Hi Barbara: Thank you for your offer to help everyone. I live in Ontario Canada and was wondering if you might have information regarding Manuife Financial - codes etc - if not do you know anyone who might have this info? Thanks for your time.

So sorry clueless on Canada codes right now

I am having a venogram in SC, I can't disclose the doctor right now. I did not go to a primary physician before I made this appt.

Do you have a specific code for this?

Thanks!

hi barbara,

i hope your plasty is very successful next week.

thanks for "holding the lantern."

i have medicare. any knowledge? thanks. aliyah

Hello jak7ham9. Thank you for your post and thank you in advance for your help. I have b.c. b.s. of Georigia, government employer/insurance. It's an HMO so I expect to need a referral. What codes do you have?

Appreciate you,
Chris

This would be good but aggrevating actually as I just dropped $6500 for business class tickets to Bulgaria for diagnosis and treatment if neccessary + $6850 = over $13000 that I may not have needed to spend.

SHIT

ok medicare/disability you can get approved for doc in anothe state if you can prove via letter that your doc(vascular surgeon or interventional radiologist) can not properly perform the procedure (can't or won't) that is extremely medically necessary and she/he is not aware of anyone else in network who can. BC/Bs georgia should be the same but deffinately look at out of network benefits. Then call tou member services and ask is you can go out of network if they can not provide you with doc who is specifically trained and experiences to handle congenital abnormaliities of the venous system (there won;t be to many of those). You generally need referall with hmo deffinately with medicar/disability DX code 474.81 Then call Sclafani in ny and get appt
You should be able to get testing done with this code too. Fun Fun Fun believe me they make you jump through hoops. So get ready to write letters , fax, beg and bug them till they help. Also saying thank you a lot is appreciated remember names the insurrance staff is used to being screamed at by the uncouth undeucated masses so a little politeness kindness and lots of notes goes a long way! Barbara Also folks remember this procedure cost less than just one year of meds which never did anything for me anyway!

Hi jak7ham9

I use Federated Insurance - Preferred One. Any help would be appreciated. Also, I have had a headache everyday for the last 8 years or so, sometimes very severe. Would this give me another alternative to possibly getting it paid for by insurance, headaches vs. MS? Thanks for your help.