P**6
发帖数: 96 | 1 【 以下文字转载自 Law 讨论区 】
发信人: Pax6 (寐), 信区: Law
标 题: 这种情况下，找律师能解决问题么？
发信站: BBS 未名空间站 (Thu Dec 6 18:04:40 2012, 美东)
大概情况，家人得了肝癌，医生已经穷尽办法，唯一可行的是一个phase I 的clinical
trial.结果现在保险公司拒付，而且是把这个trial包括的一切费用（药，诊断，手术
，住院）通通据掉。考虑请个律师，不知道能不能管用？ bow// | a****n
发帖数: 2031 | 2 俺不太懂，不过clinical trial不是批准的治疗方法，保险拒付很正常。
俺嚼着你是不是可以和做这个药品的公司协商，让他们支付所有开支？
clinical
【在 P**6 的大作中提到】
: 【 以下文字转载自 Law 讨论区 】
: 发信人: Pax6 (寐), 信区: Law
: 标 题: 这种情况下，找律师能解决问题么？
: 发信站: BBS 未名空间站 (Thu Dec 6 18:04:40 2012, 美东)
: 大概情况，家人得了肝癌，医生已经穷尽办法，唯一可行的是一个phase I 的clinical
: trial.结果现在保险公司拒付，而且是把这个trial包括的一切费用（药，诊断，手术
: ，住院）通通据掉。考虑请个律师，不知道能不能管用？ bow//
| n********m
发帖数: 37 | 3 临床研究的专用的费用是不可以报给保险公司 and medicare, and it is illegal to
do so. You insurance will ONLY be responsible to the " standard of care"
part of the costs with pre-agreement.
For phase 1 trial, most costs, if not all, are study specific. ( drug, IV,
labs, and hospitalization to receive study drug or treat study drug related
adverse events). original diagnostic tests and surgery to treat orginal
disease, event you were not joining the trial, should be " standard of care
".
Usually before enrolling into the trial, the physician's office need sent
your insurance information to their institutional clinical trial financial
management department or division to get " insurance clearance", a pre-
defined categorization of which are SOC and will be billed to Ins, which are
" study only" and bill to the study account.
Post-treatment, the hospital billing department should bill the trial/ study
specific account and get paid from there. I think the person in the
hospital who process your bill must forgot to include the study/ trial and
account information in your bill.
my suggestion :
1. check the informed consent you signed pre-study, any language about cost
......
2. contact the research physician's office and ask them to check with their
billing department.
3. call the IRB, institutional review board, to ask them to help. IRB number
should be listed on your consent.
4. let the billing office know that you are working with study team to solve
this billing mistake, so they will not send you to the collection agent: )
don't panic. if this is a legally conducted trial in a decent institution,
you will be very well covered and protected by all the laws and regulation
here in the USA.
clinical
【在 P**6 的大作中提到】
: 【 以下文字转载自 Law 讨论区 】
: 发信人: Pax6 (寐), 信区: Law
: 标 题: 这种情况下，找律师能解决问题么？
: 发信站: BBS 未名空间站 (Thu Dec 6 18:04:40 2012, 美东)
: 大概情况，家人得了肝癌，医生已经穷尽办法，唯一可行的是一个phase I 的clinical
: trial.结果现在保险公司拒付，而且是把这个trial包括的一切费用（药，诊断，手术
: ，住院）通通据掉。考虑请个律师，不知道能不能管用？ bow//
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