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Ins. denied Lovenox for being admin. in office and not self admin. any one else having the same?

Responses (2)

Inactive 18 Jun 2010

I sorry, but don't understand question

christineATU 18 Jun 2010

Bucky, I think the question means they were prescribed a medication that could be taken at home. But they had it done at the doctors office so the insurance company denied covering it. I think I understood that??? Please let me know if the question means something else?

Specialist 18 Jun 2010

We have billed Lovenox to the Insurance company more than once for several patients. This insurance changed there guidelines this year that now state this is only covered for self administered. I wanted to see if anyone else came across this problem and have done an appeal to get this overturned. Crazy thing is we always give this injection in the office and other insurance companies don't have a problem with. We have very high risk patients and they are to weak at times to self admin.

christineATU 18 Jun 2010

I copied this information for you. Most people are unable to self inject. Your insurance company should have covered this and personally, I would appeal the decision. Hope this info helps and best wishes!

"How should I use Lovenox?

Lovenox is injected under the skin. You may be shown how to use injections at home. Do not self-inject this medicine if you do not fully understand how to give the injection and properly dispose of used needles and syringes.

Lovenox is sometimes injected into a vein through an IV.

You should be sitting or lying down while receiving an Lovenox injection.

Do not mix Lovenox with other medications in the same syringe unless your doctor tells you to.

Use a different place on your stomach each time you give the injection. Your care provider will show you the best places on your body to inject the medication. Do not inject into the same place two times in a row. Do not inject Lovenox into a muscle.

Use a disposable needle only once. Throw away used needles in a puncture-proof container (ask your pharmacist where you can get one and how to dispose of it). Keep this container out of the reach of children and pets.

To be sure Lovenox is not causing harmful effects, your blood may need to be tested often. Your stool (bowel movement) may also need to be tested. Visit your doctor regularly.

If you need surgery, dental work, or a medical procedure (especially with spinal or epidural anesthesia), tell the doctor or dentist ahead of time that you are using Lovenox. You may need special care to prevent bleeding. Store at room temperature away from moisture and heat.

Do not use any medication that is discolored or that has particles in it. Call your doctor for a new prescription"

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Inactive 18 Jun 2010

Ok, I undertand now. The first time I got injections, my wife was shown how in Doctors office. The next time I was instructed on how to inject.
People with type ll Diabetes are taught how to inject, because they have to monater their blood suger and inject as needed.
It's not a big deal

Specialist 18 Jun 2010

Thanks, I have this info as well. Think I'm just going top have the Dr. right up a letter of medical necessity does in office. thanks again for all your help. free discount card

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