Blood Disorders Insurance Denial Attorney
If you or a loved one have a blood disorder, then you are familiar with the issues that often accompany this type of medical disorder. When you receive a blood disorder insurance denial, it can be difficult to know what to do. Your doctor may have prescribed a specific treatment or drug for your blood disorder, then your insurer sends you a denial. This can be disconcerting, to say the least, particularly when the treatment or drug is potentially life-saving.
Having a strong, committed attorney by your side who will never hesitate to go toe-to-toe with a big insurance company can make all the difference. There is no reason for you to deal with an insurance denial on your own—Attorney Scott Glovsky and his legal team are ready to help you through this difficult time in the best way possible. We will fight for you, helping ensure you receive the treatment or medication you need for your health.
What Are the Most Common Types of Blood Disorders?
There are many different types of blood disorders. Some of the most common blood disorders include:
- Blood clots (venous thromboembolism) are a condition that occurs when a blood clot forms in a vein, usually in the lower leg, thigh, or pelvis, but can also occur in the arms, particularly when there is a large IV central line in the vein. When a clot breaks loose and travels through the bloodstream to the lungs, it is known as a pulmonary embolism.
- Hemophilia is a disorder in which the blood does not clot normally, causing excessive bleeding. Symptoms can include large or deep bruises, joint pain and swelling, or unexplained bleeding. Treatments for hemophilia can include clotting factor injections or plasma injections.
- Hereditary Hemorrhagic Telangiectasia is a disorder in which some blood vessels fail to properly develop. A person who has HHT may have blood vessels without the tiny blood vessels known as capillaries that pass blood from arteries to veins. Some of the problems associated with HHT can be serious—even life-threatening, although when it is discovered early, there are treatments that can help manage the symptoms.
- Sickle Cell Disease is an inherited blood disorder that affects red blood cells. Those with sickle cell disease have red blood cells that contain mostly hemoglobin S—an abnormal type of hemoglobin. There is no universal cure for sickle cell disease, although it is treatable.
- Thalassemia is an inherited blood disorder resulting when the body fails to make enough hemoglobin, which is essential to red blood cells. Red blood cells carry oxygen to all the cells in the body; when there are not enough healthy red blood cells, other cells in the body are deprived of essential oxygen, causing fatigue, weakness, and shortness of breath.
- Von Willebrand Disease is a bleeding disorder caused by low levels of clotting protein in the blood. While Von Willebrand Disease is usually inherited, there are instances when the disease can develop later in life. Symptoms include recurrent and prolonged nosebleeds, excessive bleeding from a cut, bleeding from the gums, and heavy, prolonged menstrual flow.
- Vitamin K deficiency bleeding generally occurs in babies who do not have enough Vitamin K to form a clot, therefore, cannot stop bleeding. The bleeding can occur inside or outside the body; when bleeding occurs inside the body, it can be difficult to notice, therefore difficult to catch before significant damage occurs.
- Anemia is a condition in which the blood does not have sufficient healthy red blood cells, leading to a decrease in oxygen to the organs. Fatigue, paleness, lightheadedness, dizziness, an overly fast heartbeat, and shortness of breath are all symptoms of anemia.
- Blood Cancers affect the formation and function of blood cells, often beginning in the bone marrow, where blood cells are created. In most blood cancers, the uncontrolled growth of an abnormal type of blood cell interferes with the blood’s ability to perform its normal functions such as battling infection in the body and preventing uncontrolled bleeding. Leukemia is just one type of blood cancer.
What Are the Most Common Treatments for Blood Disorders?
Blood transfusions and blood and bone marrow transplants are the most common treatments for blood disorders. A blood transfusion requires a healthy donor to give blood to the person with a blood disorder through an IV inserted into a blood vessel. Whole blood, red blood cells, platelets, and plasma may all be administered during a blood transfusion. Your blood as well as the donor’s blood will be tested to ensure they are a match.
While complications from blood transfusions are rare, heart or lung problems, fever, white blood cells attacking healthy tissues, or the body’s natural defense system attacking donor blood cells can occur. A blood or bone marrow transplant can replace blood-forming stem cells that are not working properly with healthy donor cells. While blood and bone marrow transplants can cause complications in rare instances, they can also save lives.
What Medications Are Commonly Used to Treat Blood Disorders?
Some of the most common drugs used in the treatment of blood disorders include:
- Adrenochrome monosemicarbazone (Obrochrome, Xychrome, Capistat-10, Styptochrome)
- Aminocaproic acid (Hamostat, Hemocid)
- Aprotinin (Kallistat, Aprogen, Haemoprot)
- Tranexamic Acid
- Roctavian was approved in June 2023 for Hemophelia A
Why You May Have Received a Blood Disorder Insurance Denial
Your blood disorder insurance denial could be the result of a simple mistake that you can correct, or it could be something more serious. Your insurer may have denied your claim on the premise that the treatment for your blood disorder is experimental—which usually translates into “too expensive.” If your doctor has prescribed a specific treatment or medication for your blood disorder, then he or she obviously feels that the treatment could be beneficial for you. To then have the treatment denied can leave you frustrated, even angry. If you find yourself in such a difficult position, attorney Scott Glovsky can help. Scott has been helping people who are in the same situation, for many, many years with empathy, experience, and knowledge of what makes big insurance companies “tick.”
What Should You Do if Your Insurance Claim is Denied?
When your insurance claim is denied, you do have options. If the denial is due to a simple mistake, you can correct the mistake and move on. For more serious claim denials, you need an advocate in your corner who knows how to deal with a claim denial in the best way possible. You can begin with an internal appeal. Learn more about internal appeals here. If your internal appeal is not successful, you can pursue an external appeal where you can present all the reasons the treatment is necessary. The decision made at this external appeal is binding for the insurance company.
Which Insurers Are Most Likely to Deny Your Blood Disorder Insurance Claim?
Although virtually any insurer can deny your blood disorder insurance claim, some insurers are more likely to do so. Californians may have Anthem Blue Cross, Blue Shield, Health Net, Kaiser, United Healthcare, Aetna, or another insurer. Attorney Scott Glovsky has gone up against all these insurers with positive results.
What Are the Typical Costs Associated with Blood Disorder Treatments?
The costs associated with blood disorder treatments vary widely. While most of the drugs used for blood disorders are relatively affordable, some are not. The cost for medications to treat hemophilia costs an average of $270,000 annually, although when complications arise, the cost can rise to as much as $1 million. An insurance denial for a blood disorder treatment like a bone marrow transplant can be devastating. A bone marrow transplant can cost as much as $95,000 or more, while a blood transfusion can cost $3,000 or more.
How the Law Offices of Scott Glovsky Can Help Following a Blood Disorder Insurance Denial
If you’ve received a blood disorder insurance denial, contact attorney Scott Glovsky as soon as possible. When you choose the Law Offices of Scott Glovsky, you can be sure you will have someone on your side who really cares about the outcome and who will aggressively challenge your insurer with the goal of having it pay for your necessary medical treatment. Scott and his team are passionate about ensuring insurance companies honor the commitment they made to you. We understand that you may be feeling discouraged and defeated by the system. We will listen compassionately and then determine the best course of action. We believe in our clients, handling each and every case in a personal and professional manner. Contact the Law Offices of Scott Glovsky today for a free case evaluation.