enterolab and insurance

laurenla520 · Post by **laurenla520** » Sun Jul 24, 2011 11:03 pm

Hi folks, I havent been on the board in a few months, but have found myself still struggling with M.C., obviously because I have not been following a regimen and convinced myself something else was to blame. Back at square one. I find it really difficult to eliminate foods when I don't have proof that I'm intolerant so my next step is Enterolab. Has anyone had insurance pay for it? Do you need to have a dr. referral or do you just submit the billing code?

Thanks

Lauren

Martha · Post by **Martha** » Mon Jul 25, 2011 7:31 am

Lauren,

I'd advise having a doctor's referral. When I checked with my insurance company before having the tests and gave them the codes, they said that those were "routinely covered." However, after I had the tests and submitted the bill, the insurance company declined to pay because I did not have a doctor's referral.

Most people on this forum have had to pay for the tests out of pocket. I don't know whether my insurance company would actually have paid even if I had something from my doctor beforehand.

It was costly, but I now look at the Enterolab tests as money well spent. I knew what foods to eliminate without a lot of trial and error, and the tests cost less than one month's co-pay at the pharmacy for Entocort. (I bought Entocort online at lesser cost, but I think it's horrible that the insurance company wouldn't have batted an eye at paying for Entocort, but wouldn't pay for less-expensive tests that eliminated the need for the medicine.)

Martha

dgshelton · Post by **dgshelton** » Mon Jul 25, 2011 9:18 am

Lauren - I have a daughter named Lauren, who I've been trying to talk into the Enterolab tests, wiith no luck. I've even offered to pay for it. I paid for my tests out of pocket because my GI wouldn't even consider that the MC had anything to do with food intolerances. Had I known that my PCP was so open to looking at an agreeing with the test results, I would have asked him for a referral. If you have a PCP, I would start there, because unless you have a very open-minded GI, you probably won't get him or her to agree.

Best of luck!

Hugs,

Post by **tex** » Mon Jul 25, 2011 9:43 am

Denise wrote:If you have a PCP, I would start there, because unless you have a very open-minded GI, you probably won't get him or her to agree.

Excellent advice!

Hugs,
Tex

laurenla520 · Post by **laurenla520** » Tue Jul 26, 2011 3:10 am

Thanks guys, and isn't that something: It's almost odd how the GIS refuse or at least mine skimmed right over the fact that I am most likely gluten intolerant when I last brought it up.Why is that?? They want to believe that throwing pills at it is the best way? I do have really good insurance and don't have a copay for prescriptions,at least not last time, so I am thinking of starting the Entocourt again, although last time I didn't notice a significant difference. Is the Entocourt is necessecary to promote the healing of the digestive system?

dgshelton · Post by **dgshelton** » Tue Jul 26, 2011 8:01 am

The Entocort has been very helpful for a lot of us. There is a pharmacy overseas that several people here use to get their Entocort. I don't remember the name of the pharmacy, but I think a prescription for 90 is only $112. Because it is out of the country, you don't need a prescription to get it.

Hugs,

Gloria · Post by **Gloria** » Tue Jul 26, 2011 5:54 pm

Lauren wrote:I am thinking of starting the Entocourt again, although last time I didn't notice a significant difference. Is the Entocourt is necessecary to promote the healing of the digestive system?

No, Entocort isn't necessary to promote healing of the digestive system. Many people here have healed quite nicely without Entocort. It would be more accurate to say that changing the diet is necessary to promote healing. Entocort doesn't heal the digestive system; it suppresses the inflammation so that the symptoms are less severe while taking it. If you didn't notice a significant difference when you used it, it's very likely because you didn't change your diet.

Most of us who take Entocort use it to get our lives back while we determine which foods are problematic. We see Entocort as a partner, but not as a cure. Our ultimate goal is to maintain remission by diet alone.

I agree that getting the Enterolab testing will give you important information to help you jump-start your diet. Those who can't afford the test normally automatically eliminate the most common intolerances: gluten, dairy and soy. If their symptoms improve, then they know that they are intolerant to one or more of those foods.

Good luck and stay in touch. We are here to help you.

Gloria

Post by **tex** » Tue Jul 26, 2011 6:55 pm

I agree with what Gloria posted about using Entocort as part of your treatment. If symptoms are especially troublesome, Entocort helps to suppress them much sooner than the diet can do alone, which can make life a lot more pleasant, early on. However, corticosteroids do not promote healing. In fact, corticosteroids actually retard the healing process, though it is difficult to pin down just how much they might retard healing. I'm not aware of any research that has been done to quantify the effects of Entocort on healing rates, other than the general claim that they retard healing.

Tex