January 20, 2017 at 4:27 pm
I was diagnosed Nov 2016. On 12/7/16, Anthem PPO approved 6 months of IVIG in my neurologist’s office and I received a 4-day loading dose the 3rd week of Dec. Anthem stopped offering individual PPOs in my state, so I switched to an Anthem HMO effective 1/1/17. My neurologist is no longer in-network, so we did a new authorization for an in-network provider and now I’m being denied, even after the peer-to-peer. I’m very upset that this was considered medically necessary 6 weeks ago and not now. Also, I wouldn’t have put myself through the loading dose and intense side effects if treatment wasn’t to continue. I have requested help through the CIDP foundation. My doc returns from vaca Wed and will also call at that time, but the PA had zero luck with the Anthem doctor. I’ve written two Anthem reps who have been helpful in the past. Anything else I can do? I know my neurologist found me to be a borderline case, but he extensively tested me and ruled everything else out. I had an intense flare earlier this month and really would like treatment. Would appreciate any help! Thanks!
January 20, 2017 at 4:33 pm
As for tests, chronically elevated WBC (saw a hematologist and cleared for cancer). Elevated C-reactive protein. Both of these show inflammation. Elevated GAD-65 antibodies. Grossly normal MRI, grossly normal spinal tap. Aug 2016 EMG/NCS of legs, one sural nerve response missing. Nov 2016 EMG/NCS of legs and one arm, missing F-response in one nerve of both legs and evidence of demyelination in right arm. Didn’t do other arm for some reason. Diminshed or missing reflexes. Balance/propioception issues. Numbness and weakness in limbs. Issues with temperature control, digestion, orthostatic hypotension and dizziness, periods of extreme fatigue.
January 23, 2017 at 8:58 am
When I was denied and my doctor was on vacation and I was told there was no covering doctor, they suggested I see a neurologist by going through the emergency department. I wondered if this set off alarms at the insurance company and all the sudden like magic they approved my in-home infusion treatments of IVIG for CIDP. I never got past the emergency department waiting room, having been seen by an emergency department triage nurse or PA. They were about to send me to for a blood work up, but I told him it was not necessary, I was just there for a neurology consult to push the insurance company along. My neurologist and their office is affiliated with the hospital emergency department.
January 23, 2017 at 12:22 pm
Thank you surfnyc. Are you saying that when you registered in the emergency department before being seen, the insurance company somehow approved the treatment?
February 21, 2017 at 3:27 am
Update, was finally approved! Had treatment last Friday.
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