I need guidance from MS community please. State of GA insurance moved from UHC to BC/BS. I had to purchase the gold ($$$$) plan. I got a letter saying my tysabri treatment is pending. They are requesting: MD office notes and exam findings, Diagnostic testing results, Previously tried treatment and medication and other info to support this request. I have been on Tysabri for 4 years. The letter was sent to me and the infusion center. I know I won't get a treatment this month now. Do I have to get all of this from my doctor and sent it. Who else is dealing with this mess. Thank you for your comments,.
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[QUOTE=Prissy;1440666]I need guidance from MS community please. State of GA insurance moved from UHC to BC/BS.
Seems to me that your ms neuro needs to send the required info to insurance company. I would call neuro or neuro nurse to remind them. -
So sorry you are going through this with your insurance company. Unfortunately, it sounds like your doctor will have to provide all of the necessary documentation...hopefully this won't be a problem.
Sounds like the insurance company is trying to determine if the doctor is using Ty as a second line of defense, and wants to see that other DMDs have been tried (unsuccessfully).
Good luck!Comment
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Call MS Active Source first thing tomorrow and speak to Sidney if you can. Tell her that Tyabri has been effective for you and your new insurance company has yanked it. You can Google the 800 number, not sure if I can post it. Have your insurance information and neurologist's contact information. Push for an emergency phone consultation if you can.Comment
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