To continue our fun medical saga...
We had a series of tests done a while back to try to figure out what was going on with Piper's immune system. Things went smoothly and we found out what we needed to. A few months after that, we decided to get Makenna tested for the same things to see if she had the same problems (so we could fix things before they got bad). After that test, we got a notice from the insurance saying it wasn't covered because it fell into the "experimental or investigational" category. That alone confused me, because aren't ALL tests "investigational"? If not, why do the test? :)
Anyhow, we had the lab and our doctor appeal the decision because it is actually medically necessary. One of the bits of ammunition I gave the most recent lab was that we had this done earlier, and we didn't have anything rejected from the first round.
Today, I got a bill from the first lab -- FOR $2500! Turns out they submitted everything to the old insurance, so it still hasn't been processed by Aetna. This is where I start to worry a bit with their "experimental or investigational" definition. ALL the tests they ran the first time would be "investigational" because we had no idea what was going on.
At least the first round of tests was set in by a specialist (infectious disease doc). The one that was rejected was just our pediatrician, so coming from a doc a bit higher up the food chain may help get everything covered.
This could get interesting.
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