Insurance won't pay for calprotectin fecal test

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Joined
Jul 8, 2012
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Blue Cross Blue Shield doesn't want to cover the calprotectin fecal test. I am fighting their refusal but has anyone else had this problem. Basically they said it was not a medically approved test. I was really surprised by their refusal.
 
The calprotein fecal test is not covered in Australia either. In our case I have the choice of two labs, one charges $40 and the other $75.
 
BCBS wouldn't pay for it for my son either. They claim that the medical journals don't show that it is a valid test for crohn's disease. I tried fighting and having the doctor submit documentation but ended up paying the $285 to the hospital for the test.
 
Wow, that infuriates me. While it doesn't diagnose Crohn's, it's such an important test for so many other reasons.

*goes off to kick something*
 
I figure we will be facing this issue as well as we just recently had the test done and also have BCBS. The doc even mentioned it not often being covered, I told him I didn't care I still wanted it done.
 
Our doctor ordered the test again today, last was about a year ago. I did find a sample pre-authorization letter on CCFS.org site for the calprotectin test. I plan to see if docs office will submit to bcbs. If they deny will still need to test anyway.
 
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