Synagis

websterhome · Dec 18, 2008

Hello! I'm having a frustrating time dealing with our insurance company (Regence PPO) on covering the RSV antibodies called Synagis. Does anyone out there have a recommendation or experience in this area? We are just beginning the second & final appeal. An attorney I spoke with recommended providing the insurance company with lots of peer review literature, abstracts - as many articles as possible stating the benefits of Synagis to RSV patients. We also had our CF doctor write a letter of medical necessity on the first go around appeal, but it wasn't enough. Has anyone received the vaccine? If so, what insurance company do you have? Thank you!

websterhome · Dec 18, 2008

Hello! I'm having a frustrating time dealing with our insurance company (Regence PPO) on covering the RSV antibodies called Synagis. Does anyone out there have a recommendation or experience in this area? We are just beginning the second & final appeal. An attorney I spoke with recommended providing the insurance company with lots of peer review literature, abstracts - as many articles as possible stating the benefits of Synagis to RSV patients. We also had our CF doctor write a letter of medical necessity on the first go around appeal, but it wasn't enough. Has anyone received the vaccine? If so, what insurance company do you have? Thank you!

websterhome · Dec 18, 2008

Hello! I'm having a frustrating time dealing with our insurance company (Regence PPO) on covering the RSV antibodies called Synagis. Does anyone out there have a recommendation or experience in this area? We are just beginning the second & final appeal. An attorney I spoke with recommended providing the insurance company with lots of peer review literature, abstracts - as many articles as possible stating the benefits of Synagis to RSV patients. We also had our CF doctor write a letter of medical necessity on the first go around appeal, but it wasn't enough. Has anyone received the vaccine? If so, what insurance company do you have? Thank you!

websterhome · Dec 18, 2008

Hello! I'm having a frustrating time dealing with our insurance company (Regence PPO) on covering the RSV antibodies called Synagis. Does anyone out there have a recommendation or experience in this area? We are just beginning the second & final appeal. An attorney I spoke with recommended providing the insurance company with lots of peer review literature, abstracts - as many articles as possible stating the benefits of Synagis to RSV patients. We also had our CF doctor write a letter of medical necessity on the first go around appeal, but it wasn't enough. Has anyone received the vaccine? If so, what insurance company do you have? Thank you!

websterhome · Dec 18, 2008

Hello! I'm having a frustrating time dealing with our insurance company (Regence PPO) on covering the RSV antibodies called Synagis. Does anyone out there have a recommendation or experience in this area? We are just beginning the second & final appeal. An attorney I spoke with recommended providing the insurance company with lots of peer review literature, abstracts - as many articles as possible stating the benefits of Synagis to RSV patients. We also had our CF doctor write a letter of medical necessity on the first go around appeal, but it wasn't enough. Has anyone received the vaccine? If so, what insurance company do you have? Thank you!

boman4802 · Dec 18, 2008

Hi! We have just finished fighting this battle with our insurance also. They first denied the synagis...but when my daughters CF doctor wrote a letter of medical necessity they then approved it. They also approved home health to come out and give it once a month. We do have to pay 20% copay on the medicine alone...which amounts to about $350 a month. It might be helpful to get your CF clinic involoved (if they are not already) possibly the social worker could help...as they seem to have a lot of connections. Definitely keep trying...I hope you get somewhere with them! Also, our insurance is IBEW-a part of Coventry and First Health Direct. Hope this helps!
Andrea

boman4802 · Dec 18, 2008

Hi! We have just finished fighting this battle with our insurance also. They first denied the synagis...but when my daughters CF doctor wrote a letter of medical necessity they then approved it. They also approved home health to come out and give it once a month. We do have to pay 20% copay on the medicine alone...which amounts to about $350 a month. It might be helpful to get your CF clinic involoved (if they are not already) possibly the social worker could help...as they seem to have a lot of connections. Definitely keep trying...I hope you get somewhere with them! Also, our insurance is IBEW-a part of Coventry and First Health Direct. Hope this helps!
Andrea

boman4802 · Dec 18, 2008

Hi! We have just finished fighting this battle with our insurance also. They first denied the synagis...but when my daughters CF doctor wrote a letter of medical necessity they then approved it. They also approved home health to come out and give it once a month. We do have to pay 20% copay on the medicine alone...which amounts to about $350 a month. It might be helpful to get your CF clinic involoved (if they are not already) possibly the social worker could help...as they seem to have a lot of connections. Definitely keep trying...I hope you get somewhere with them! Also, our insurance is IBEW-a part of Coventry and First Health Direct. Hope this helps!
Andrea

boman4802 · Dec 18, 2008

Hi! We have just finished fighting this battle with our insurance also. They first denied the synagis...but when my daughters CF doctor wrote a letter of medical necessity they then approved it. They also approved home health to come out and give it once a month. We do have to pay 20% copay on the medicine alone...which amounts to about $350 a month. It might be helpful to get your CF clinic involoved (if they are not already) possibly the social worker could help...as they seem to have a lot of connections. Definitely keep trying...I hope you get somewhere with them! Also, our insurance is IBEW-a part of Coventry and First Health Direct. Hope this helps!
Andrea

boman4802 · Dec 18, 2008

Hi! We have just finished fighting this battle with our insurance also. They first denied the synagis...but when my daughters CF doctor wrote a letter of medical necessity they then approved it. They also approved home health to come out and give it once a month. We do have to pay 20% copay on the medicine alone...which amounts to about $350 a month. It might be helpful to get your CF clinic involoved (if they are not already) possibly the social worker could help...as they seem to have a lot of connections. Definitely keep trying...I hope you get somewhere with them! Also, our insurance is IBEW-a part of Coventry and First Health Direct. Hope this helps!
<br />Andrea

Ratatosk · Dec 18, 2008