Medication and ins question

Discussion in 'General Parenting' started by DownTheRabbitHole, Jan 29, 2013.

  1. DownTheRabbitHole

    DownTheRabbitHole New Member

    So I'm taking my son to Psyc doctor tomorrow. It was about time to see him anyway but I called to try and be worked in because of his behavior lately. Anyway his medications especially his ADHD medication, Focalin don't seem to be as effective for the last couple of weeks. And boy did I ever notice it this morning. Anyway it's obviously getting worse and I didn't want to waste anytime. He has had 3 referrals and or class removals this month alone.

    It has been since August since we have seen this Psyc, and I'm concerned we might need an adjustment in his medications and I'm sorta anticipating Psyc to send us for bloodwork. Not so much to check the Focalin but my son also takes Depokate and Intuniv. And he usually checks the levels of the Depakote and the usual other enzyme levels etc. the thing is last time I took him the lab billed me over 900 for the labwork. At first I thought they had something wrong with the ins. so I verified and asked then to re file through ins. But I'm still being billed. I've been sort of ignoring it but was wondering if they exclude certain doctor visits and other claims coded under mental illness would this include bloodwork.

    Our previous ins got out of medical and sold our acct to BCBS and I just don't recall if we ran into this problem before. In general we get little to no coverage for mental health claims but the blood work thing is new. Anyway it's not like it can be avoided. I'm going to request being sent to a different lab, until I can make payments on that ridiculous previous bill. Does anyone think I can request if pediatrician can send us for bloodwork just to check everything out and then maybe it won't be considered under mental just medical and maybe they will cover. Only I'm not sure if the orders would include the specifics Psyc needs to review. Maybe my first idea of changing labs will work best.

    I just don't understand why it should mater what doctor requests the bloodwork regardless of the cause if his liver and other things need to be checked wouldn't that still fall under regular medical care.
  2. jal

    jal Member

    I would take a look at your policy with BCBS. I had them several years ago when difficult child was taking Depakote and needed his levels monitored. I never was billed for lab work. Now the mental health portion I undestand. We were using a psychiatrist who did not take insurance. My BCBS plan had a mental health deductable and once that was met they then picked up 80%, but it was up to me to submit the paperwork and have myself and my employer stay on their tail to make sure I was reimbursed.
  3. dstc_99

    dstc_99 Well-Known Member

    It could be that they wont cover the bloodwork if it is ordered by the psychiatrist (maybe he isn't authorized to order the blood work through BCBS). Most likely they would cover it if it were ordered by his pediatric doctor.

    Only way to know for sure is call them and find out.
  4. confuzzled

    confuzzled Member

    i have bc/bs and i have to use a specific lab (labcorp) could be that if you are having it done by the dr that he is sending it to the wrong lab.

    i would call bc/bs and specifically ask what lab you need to go to and then just get a labslip...i've never once been charged for labwork for any sort of tests, no matter who orders them.