Insurance won't pay for calprotectin fecal test

[Fiona's Mom]

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.

 

[Catherine]

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.

 

[David]

Stupid insurance companies.

What does not being medically approved mean?

 

[Tea]

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.

 

[David]

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*

 

[Clash]

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.

 

[Tea]

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.

 

[my little penguin]

Our bs covered it twice but pill cam not so much.
I really think they pick and chose randomly.