Initial Blood work for Defy

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Goose

New Member
I'm thinking of going ahead with Defy for my TRT needs. It will be a around Dec. before I can get to it, but I am reading and learning all I can before that time comes. One question on the blood work I am unclear on. Can I get a script from Defy and run the blood work through my (Blue Cross) insurance? My insurance uses Labcorps anyway. Also, Is there a cost for the script? Or do you pay defy and go to Labcorp and get the test ran?

Thanks
 
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Goose

New Member
Vince, how manny labs do they cover per year? I think mine works the same way. Although, they have added certain test to a list that has to be preauthorized.
 
Nope, when Obamacare came along the cost of my employer sponsored insurance tripled in cost and I have to go the the High Deductible option that has a 20% copay on lab work after your deductible is met.
 
You'll have to check if your insurance covers an out of state out of network physicians lab prescription. You'll want to make sure, because if they don't, the lab will bill you directly.

I think Defy will require that you pre pay for your initial consult before sending you the prescription.

You could also buy the labs directly from Defy. That works like many other order your own blood test websites, and you just go to a labcorp. If you have any doubt if your insurance will cover your labs, I'd go that route.

Plus, with my current insurance, they aren't very clear if they'll cover the sensitive E2 test or not. They claim because it's considered "fertility".
 
Also consider that you can or could file claims on your own with your inusrance carrier, I tried this early on (not w Defy) and it was a major hassle to do the paperwork and have it rejected for the smallest of errors. I was able to get some partial payments back on blood work but it was a MAJOR headache. There were plenty of positives to coming to Defy and this was one of them.
 

FabFred

New Member
Seriously? I was never given an option for blood work but I also have that same 100% coverage via Quest with insurance... Just emailed them about it....
 

Esq

Member
I also have Anthem, and spent some time chatting online with an Anthem rep month or two ago about this. Here is what I was told (posted to another thread at the time):

I just spent over an hour chatting online with Anthem about this, and the response I got from the rep I chatted with matches up 100% with what HarryCat was told. Labcorp and Quest both submit claims showing the location of lab services as where the referring physician is located (in this case, Florida) regardless of the state where the blood draw takes place.
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According to Anthem: "The referring provider is out of network and located in Florida. Even though the rendering provider is in network and is located in Kentucky, it will be filed in the state of the referring provider which is Florida. I called Florida, Quest diagnostics and LabCorp is out of network with Florida. So if you have the labs done, it will be out of network because it will be filed with the state of Florida."
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When I pointed out that the "Find A Doctor" tool on their website shows Quest in Tampa as being in-network for my plan, she didn't really have a solid response other than to say that she called Anthem in Florida and was told LabCorp and Quest are both out-of-network for my plan in Florida, and therefore it would be treated as out-of-network. She also referred to the online disclaimer that the "Find A Doctor" tool might not be accurate. It makes absolutely no sense to me, but to try to get the labs covered after-the-fact and after this chat would be a very risky move.
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Bottom line, at least for my plan (which does not specify between in-state and out-of-state benefits), Anthem would process the Defy labs as out-of-network regardless of the lab. I'll keep paying the Defy rate it looks like.
 

hva

Member
You will have to pay Defy the initial consult fee of $250 up front before they will write you the lab order. They will also require a disclaimer on file with them stating you understand your bill from the lab could be much higher if your insurance happens to reject payment. Now that I'm an established patient they will write a lab script any time I would like and my insurance pays. It's cheaper in the long run if your insurance will pay.

Since I don't live in Florida Quest has to do an internal insurance authorization every time I go to the lab, which takes about half an hour, but it's worth it since my insurance ends up paying most of the lab cost.
 
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