Hello Everyone-
My Nero wants me to get this GQ1B test, and I was wondering if anyone had got the test done. This test is going to be optional for me, because my insurance thinks its experimental.
Kim
Did he/she give a reason why the test is needed? Has your GBS case been confirmed?
They are like 90% sure it is GBS with Miller Fisher variant. I am a little worried, because I went back to work, and now my double vision and numbness is coming back.
The GQ1B test is definitely used to rule in/rule out the Miller Fisher GBS variant.
Has a Denial been issued/sent to you? Were you ever informed of any Denial over the phone? Get one in In writing?
Don't want to alarm you but GBS treatment typically needs to begin within a week or so of symptoms showing up by and large for treatment to have decent odds of helping prevent or minimize the potential for damage to occur. The further out from that the lesser the degree for having a truly positive response.
"Experimental" is usually Insurance- speak for "Denied".
As in all things, Insurers have to respond to Appeals. In this instance you would be better served if the MD specialist gets involved by requesting an EXPEDITED APPEAL directly to the Insurer on your behalf. He/She needs to include info as to nature of the test, why it is needed Now (as in you don't have 30 days to wait to get a response) and any other tests (if there are any) that can provide the same response to rule in or rule out this particular GBS variant.
All Commercial and Medicare Insurers by law have to have an Appeal process in place. Do you know what yours is?
All Insurers also, by law, have to have a way to request an EXPEDITED APPEAL where there is substantial risk to the member/patient by having to wait the standard 30 days for a Regular Appeal response. You as the insured person can do it via phone or in writing, a Designee can do so for you (you need to sign something allowing them to do so for you ideally), or Best of All, the requesting MD specialist can do so on your behalf.
Call your Insurer to find out the phone or Fax number for an EXPEDITED APPEAL. Call the requesting MD specialist's office and ask or direct them to submit an EXPEDITED APPEAL on your behalf ASAP, providing them with the phone number and/or Fax number for your Insurer. If they hem and haw, say you have to speak directly with the MS specialist by day's end and ask him/her to do so. If he/she refuses, you may need to think about poss having to find another specialist willing to go to bat for you on your behalf. And/Or request an Expedited Appeal on your own- being prepared to provide the name, phone and fax number of the requesting MD specialist then telling that person's office to stand by as records and medical justification will need to be sent in quickly on your behalf.
So sorry to hear you are stuck with this now. Not sure if this option was ever identified to you let alone whether or not you have received a Verbal or Written Denial by your Health Insurer.
Don't be afraid to Fight Back.
Best wishes for a positive outcome,
LJ