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Thyroid, Pregnenolone, Progesterone, DHEA, etc
Thyroid, DHEA, Pregnenolone, Progesterone, etc
HCG Coverage : Insurance Appeal, please help!
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<blockquote data-quote="Gokk" data-source="post: 61393" data-attributes="member: 6209"><p>Dear All,</p><p>This year my insurance has denied coverage of HCG (while they covered it last year). They introduced new requirements, specifically they wanted to see the results of blood work prior to the start of TRT. In such blood work my total testosterone was 288ng/dL with a lab range of 270-1070. They say that because my result was within the lab range I cannot claim to suffer from low testosterone!</p><p>I am now preparing my appeal which is based on the following key points:</p><p></p><p>1) even though my result was indeed within the lab range (which is just a statistical figure and not the result of clinical assessment) such result was well below the 300ng/dL threshold which is generally considered the cut-off value for the diagnosis of Hypogonadism.</p><p></p><p>2) following the above test, I arranged on my own, through discounted labs, another test (which was not shown to my insurance) performed at a Labcorp lab, and this time my result was 292ng/dL, higher than in the previous case but well outside the lab's normal range: 348-1197.</p><p></p><p>While I do think that point 2) above should be sufficient to overturn the initial decision of my insurance, I am trying to compile a list of references to support point 1) above. I have already found quite relevant material (for instance the Endocrinology Guidelines for the diagnosis of Hypogonadism where they confirm 300ng/dL as the cut-off value).</p><p></p><p>I would therefore be very grateful if you could please point out any relevant study which I can cite in my appeal to support the thesis that 300ng/dL is indeed generally considered the cut-off value for the diagnosis of "Low Testosterone" (together with the assessment of symptoms of course).</p><p></p><p>Thank you very much for your help</p></blockquote><p></p>
[QUOTE="Gokk, post: 61393, member: 6209"] Dear All, This year my insurance has denied coverage of HCG (while they covered it last year). They introduced new requirements, specifically they wanted to see the results of blood work prior to the start of TRT. In such blood work my total testosterone was 288ng/dL with a lab range of 270-1070. They say that because my result was within the lab range I cannot claim to suffer from low testosterone! I am now preparing my appeal which is based on the following key points: 1) even though my result was indeed within the lab range (which is just a statistical figure and not the result of clinical assessment) such result was well below the 300ng/dL threshold which is generally considered the cut-off value for the diagnosis of Hypogonadism. 2) following the above test, I arranged on my own, through discounted labs, another test (which was not shown to my insurance) performed at a Labcorp lab, and this time my result was 292ng/dL, higher than in the previous case but well outside the lab's normal range: 348-1197. While I do think that point 2) above should be sufficient to overturn the initial decision of my insurance, I am trying to compile a list of references to support point 1) above. I have already found quite relevant material (for instance the Endocrinology Guidelines for the diagnosis of Hypogonadism where they confirm 300ng/dL as the cut-off value). I would therefore be very grateful if you could please point out any relevant study which I can cite in my appeal to support the thesis that 300ng/dL is indeed generally considered the cut-off value for the diagnosis of "Low Testosterone" (together with the assessment of symptoms of course). Thank you very much for your help [/QUOTE]
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Thyroid, Pregnenolone, Progesterone, DHEA, etc
Thyroid, DHEA, Pregnenolone, Progesterone, etc
HCG Coverage : Insurance Appeal, please help!
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