Nuchal Translucency Test?

Question

Please help. If ever the medical and insurance industries have confused me, it is now.

My doctor has prescribed me an Ultrascreen (Nuchal Translucency). He performs this test in his office. Other insurance companies cover the procedure when he does the test, but my insurance company will not cover him to do the test.

When I contacted my insurance company, they indicated to me that, in order for them to cover the test, the clinician must be credentialed with the Nuchal Translucency Quality Review Program. When I looked at the site, one physician in my entire county in metro NY (densely populated) is credentialed according to the NTQR.

Is this my insurance company being difficult or can most sonographers in OB offices do this test?

My doctor does this test in his office. My friend had this test done by her doctor - AND her doctor is not listed on this NTQR Web site.

I just don't know what to believe.

Answer 1

That does sound a little ridiculous, as, from their website, the whole credentialed clinician thing looks like a relatively new thing. My doctor is not listed and her ultrasound technician did the ultrasound part of the Nuchal Translucency test. The lab that she used for the bloodwork part is listed as a participating lab. That really sounds like your insurance being difficult rather than any sort of valid requirement.

Answer 2

I had this test performed when I was 12 weeks but had to go to a special hospital as my doctor at that time didn't do any ultrasounds.

I would talk to your doctor about this. I'm sure there is a way they can code the bill so that your insurance company will pay for it. As long as the ultrasound is deemed necessary by your doctor they should pay for it.

Best of luck!

Answer 3

sorry I cant help..best of luck and those darn insurance companies are ALWAYS being difficult...