Won my Oncotype dx appeal!

Yes, Urbie, that is good news.  Too bad it takes a lawsuit to make them do what's right.

I had read that Blue Cross/Blue Shield of Michigan lost what amounted to a class action suit, I think last year, over the same issue.  BC/BS was claiming the Oncotype test was investigational, and they weren't paying the claims.  Yet, while the suit was underway, they quietly changed their own policy and began paying for the test ... but not retroactively.  In the meantime, a huge number of insurance companies in other states began paying for the test.  Once the clinical oncologists' professional organization and the National Comprehensive Cancer Network adopted Oncotype testing as a standard of care for early, node-negative, ER+ BC, there was no more excuse; and BC/BS lost the case.  I think Michigan forced them to pay retroactively, up to a certain date.

I received a letter from Genomic Health a few weeks ago, informing me that they were going to contact my insurance company about payment.  I haven't heard from them since then, but I haven't received a claims statement yet, either.  My insurance is supposed to be good; I sure hope they don't balk at this.

otter 

I really don't understand why the insurance companies are balking at this.  In the long run, it could save them millions of dollars.  One chemo tx alone costs more then the test.  Wouldn't it be to their advantage to use the test and thus avoid paying for chemo?  Like large corporations, the insurance companies look at the short-term savings, not the big picture.  They're cutting off their nose to spite their face.