My Ttt Is Not Being Covered By Insurance!!

[sue1234]

I am floored! I had this done LAST October, and I just got a letter yesterday saying they are not covering it. They claim it was not warranted and investigational.

So, how does someone who gets lightheaded get "tested" for why they are lightheaded? I can't drive, work, etc., so it is a pretty prominent problem for me. What is there left to do if you go to a cardio and say you are lightheaded and get a racing heart from standing? Most cardios and neuros will use a TTT. The one I had done 3 years ago was covered by the same insurance, so I don't know what gives.

I typed in "TTT not covered by insurance" and came up with various insurance sites that say it is NOT covered in people who do not faint. It even says it is not covered in people with dysautonomia. Has anyone else run into this? Is this a new policy for others, too?

[toddm1960]

I'm floored (no pun) an insurance company finding a way to pull needed coverage. I'm shocked they didn't tell you dysautonomia was a pre-existing condition so your TTT isn't covered! I'm sorry but insurance companies add no value to medical care, and their only two ways to maximize profits, increase premiums or cut care......and we're getting both.

I can't get coverage for drugs and cofactors I need also so I have no use for insurance companies or politicians that protect them.

Sorry that's my venting for the day.

[Rachel]

I am so sorry that coverage for your TTT has been denied. It has been over 15 years since I had my TTT, and I have no idea if it was covered by insurance back then or not. I was still a kid, and my parents paid all of my medical bills.

Can you appeal the decision? If insurance still denies the claim, then you could look into financial aid options at the hospital. If they don't offer financial aid, then you can probably at least get a discounted price if you are paying by cash. They give insurance companies discounts all the time, and I have found that they often give discounts to patients paying out of pocket too.

One way or another, I hope that the bill will be manageable for you and that it won't cause you too much stress.

Rachel

[issie]

Insurance companies try to not pay things. You can put in an appeal and ask for another review. You have to do it in writing and submit your records showing the need for the test. Call the place and tell them you have an appeal in and they won't bother you for payment, until the appeal is reviewed. Tell them to make a note on your file. You may have to call if it takes awhile and remind them you are trying to get an appeal approval. Then if all fails, sometimes, they will write some of it off, or arrange for assistance etc. like the other person suggested.

[nmorgen]

I would definitely appeal it. You need to actualy look at your policy and see what they will cover. I'm not sure if it's from your employer or your spouses, but you can go to HR and ask for a copy of your policy. Some tests require preapproval before they are done. If this is the case you need to contact the physicians office that performed the test and ask about it being pre approved. Get any information you can from the drs office. They are usually happy to give you any help you need to get insurance to pay. Also, have them check and make sure that it was filed correctly. I had a dr's office file the wrong date and it was denied, but they refiled it properly and got paid.

You really should know what your policy covers and what it doesn't. Doing a search on the internet doesn't really help you, as most policies are completely different and usually based on what your employer has decided to carry.

I hope your able to get it straightened out. If your insurance does decide not to pay, try to make arrangements for a payment plan, or if you have the money ask if they will give you a discount for paying it off at one time. You can sometimes get up to 30% discount by doing this. I have to say that if it's not a private facility, but gets funding from the gov they usually wont offer you any discount, b/c they don't have to worry about getting their money.

[houswoea]

That's stupid. What test isn't investigational? It's a test!!! Duh!!!

I feel like that's saying that you shouldn't get a pap smear or a blood test or a MRI for headaches... you have the symptom, you need the test. Stupid.

[pat57]

I would have that appeal sent by the Dr. I think that's your best bet.

good luck

[sue1234]

Thank you all for your responses. I am probably not going to do anything unless the dr.s office bills me. I THINK my dr.s office is likely to appeal, as the letter said if a doctor wants to appeal, they can call and talk to one of the insurance doctors. Sounds like he would make more headway than I would.

It is just ridiculous. Now, whenever ANY doctor wants to do testing other than basic labwork, I am going to have to insist that they contact my insurance and make sure it is covered. I know for MRIs and such, they already do. So, now things like TTT and such????

[issie]

Thank you all for your responses. I am probably not going to do anything unless the dr.s office bills me. I THINK my dr.s office is likely to appeal, as the letter said if a doctor wants to appeal, they can call and talk to one of the insurance doctors. Sounds like he would make more headway than I would.

It is just ridiculous. Now, whenever ANY doctor wants to do testing other than basic labwork, I am going to have to insist that they contact my insurance and make sure it is covered. I know for MRIs and such, they already do. So, now things like TTT and such????

Unfortunatly, you are responsible for how your bill gets paid. Unless your doctor agrees to do an appeal, (they usually won't), it's up to you to do the appeal. I used to be an insurance biller and that's how it works.

[nmorgen]

Issie is right. Not only that, but you are also given a time frame to appeal, and then it is totally your responsibility to pay. Call your doctor and see if they will appeal it before you just chose to ignore it.

[nunntrio]

My insurance company initally denied my TTT as not necessary. I appealed it and pretty quickly got it overturned (A copy of my test was sent to them showing I failed). My Dr. was actually willing to help out once I contacted them but I am not sure if that is the norm. Everyone is correct that there is time limit to file the appeal so I would not hesitate in getting it started.

Good Luck

[iheartcats]

I would appeal, too.

I haven't had a TTT as I was warned insurance companies like to deny them.

[comfortzone]

Just curious - how much does that TTT cost? I have a neuro appt. tomorrow & now wonder if such specific tests are ordered if I should ask the clinic to get approval for my testing first......it's at the Mayo in AZ....does asking for pre-approval get them upset? If you turn down a test because it's financially impossible (where you initially thought all the tests would be covered) = wow that could upset a doc I bet......

I've lived with medical debt for many years now - have written appeals etc....it can seem a full time job manageing it all at times =

Happily though I've found docs to be pretty awesome in helping how they can.......had one group write off almost 900 dollars for anesthesia a few years back - then it seems the insurance company is getting sued and I'm entitled to reward - never mailed the papers in - but it was good to read it just the same - they were getting sued for denying claims = to the tune of 350 million minimal = poor insurance company (yeah right! lol)

Best wishes for this to be resolved to your benefit

[issie]

Just curious - how much does that TTT cost? I have a neuro appt. tomorrow & now wonder if such specific tests are ordered if I should ask the clinic to get approval for my testing first......it's at the Mayo in AZ....does asking for pre-approval get them upset? If you turn down a test because it's financially impossible (where you initially thought all the tests would be covered) = wow that could upset a doc I bet......

I've lived with medical debt for many years now - have written appeals etc....it can seem a full time job manageing it all at times =

Happily though I've found docs to be pretty awesome in helping how they can.......had one group write off almost 900 dollars for anesthesia a few years back - then it seems the insurance company is getting sued and I'm entitled to reward - never mailed the papers in - but it was good to read it just the same - they were getting sued for denying claims = to the tune of 350 million minimal = poor insurance company (yeah right! lol)

Best wishes for this to be resolved to your benefit

If Mayo is a provider for your insurance, they probably will check to make sure it is paid before they do it. It never hurts to ask a question though. One of my test there was considered investigational and not the usual way of testing --- they did write it off.