Entyvio Connect, Revisited

One of the most popular posts on my blog is one from last year, A Guide to Using Entyvio Connect. I guess that isn’t surprising, since I wrote the post after experiencing much confusion and inconvenience trying to get Entyvio Connect to reimburse my health care provider for the cost of my Entyvio infusions. I’ve been meaning to update that post after having been through the process again this year, but I’ve been dreading it. I wish I had better news, but it was just as dizzying this year.

Most of the information in that post still applies, and if you are trying to navigate this process, I suggest you read it first and then read this.

Now that you’re back, a few things have changed:

  • The ID numbers. After reenrolling in Entyvio Connect last June, a year after I had first enrolled, they made me reenroll again at the beginning of this year and inexplicably sent me a new enrollment package with all new information, including my ID number. While this was a bit baffling, they sent me an Entyvio Connect card, which is basically like an insurance card, and the numbers on it correspond with familiar insurance number terminology, which makes things a little less confusing for your provider.
  • The mailing address. The address I posted on my blog last year no longer applies. If you need it, I suggest you contact Entyvio Connect and make sure you have the current information.

I expected the process to go more smoothly for me this year after having been through it last year, but unfortunately that was not the case. I started off going through the same steps I tried last year: when I received my hospital bill, I called the billing office and asked that they bill Entyvio Connect like a secondary insurance and provided the new information. Last year, they had told me that they are unable to fax claims, so I provided them the new mailing address. I also faxed my Explanation of Benefits from my insurance company to Entyvio Connect.

This year, Entyvio Connect was slightly more responsive in that they at least sent me several letters over the course of the next month or two informing me that my provider had not sent the claim form. I also received additional bills from my provider. I followed up with the billing office multiple times and each time they said they would mail the claim form. I also spoke to someone at Entyvio Connect, who suggested that I ask the provider to send me the claim form and I could fax it to Entyvio Connect myself. I tried that, but what my provider mailed me was an itemized bill, which apparently was not what I needed. The billing office then told me that they could not mail me a claim form, and I asked them again to send it directly to Entyvio Connect.

Finally, I called the billing office and asked to speak to a supervisor (which is something I’ve never done before and was terrifying). At this point, I was under the impression that my provider had not actually been mailing the claim form. The supervisor was very nice and said that the claim form had in fact been mailed on multiple occasions. She offered to mail it again. Not knowing what else to do but not having much hope that this would ever get straightened out, I agreed. She then suggested that she fax the claim form.

It was at this point that my head exploded.

Entyvio Connect had said repeatedly that they prefer to receive claims via fax and that they would get processed faster that way. But since someone at the billing office told me last year that they can only mail claims, not fax them, I thought that was a nonstarter. I’m not sure if that individual was wrong, or if their policy changed. But now the billing office was able to fax the claims (at this point, it was three infusions that I was trying to obtain reimbursements for).

Once the claims were faxed, they were processed in a matter of weeks.

I have heard from others who have had problems with this process, and I wish I had some easy solution or better advice. All I can say is that as frustrating as it is, keep at it with both Entyvio Connect and your provider until you can get it figured out, because it will save you a lot of money in the end. Also, speaking with a supervisor is not nearly as scary as it sounds, and sometimes will get you where you need to be faster than you would otherwise.

Who knows, maybe by next year they’ll have changed the process again and it will actually be better.