An analysis of AAN′s evidence-based guideline for IVIg use in neurologic disorders: Provider impact and payer perspectives
Open accessAbstract
Health insurers look for reliable, published evidence such as evidence-based guidelines put forth by medical specialty societies to craft their coverage policies. These guidelines generate both beneficial and controversial consequences on policies. Coverage policies aim to address the most typical clinical presentations. The American Academy of Neurology guideline for IV immunoglobulin strengthens the case for coverage when it is used to treat Guillain-Barré syndrome and chronic inflammatory demyelinating polyradiculoneuropathy. The guideline is less likely to strengthen coverage for several other diagnoses with lower levels of evidence. The responsibility to clarify specific situations when patient need falls outside of what is considered to be routine evaluation or treatment rests heavily on the physician. Advice on appealing an unfavorable coverage decision is also provided to the reader.
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When a patient has comorbidities or unusual features outside routine evaluation or treatment, clinicians often must provide additional justification or supporting documentation to request individual consideration or challenge unfavorable coverage decisions.
“However, when a patient has comorbidities or unusual features that fall outside routine evaluation or treatment, it is often the clinician who must provide additional justification or supporting documentation to request individual consideration or to challenge unfavorable coverage decisions [321].”
From Toward Safer Diagnoses: A SEIPS-Based Narrative Review of Diagnostic Errors (2026) · cites this paper as [321]
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Cites
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Satya‐Murti, S. (2018) · Neurology Clinical Practice · doi:10.1212/cpj.0000000000000515
Self-citation
- Authors
- Satya-Murti, S., Shepard, K. M., & Kaufman, J. M.
- Affiliations
- Health Policy Consultant (SS-M), Santa Maria, CA; American Academy of Neurology (KMS), Minneapolis, MN; and Department of Neurology (JMK), Rhode Island Hospital and The Warren Alpert Medical School of Brown University, Providence, RI.
- Brown University (US)
- Corresponding author
- Shepard, Katie M.
- ORCID
- Shepard, Katie M.
- Venue
- Neurology Clinical Practice
- Published
- 2012-06
- Volume
- 2
- Issue
- 2
- Pages
- 134-138
- ISSN
- 2163-0402 (ISSN-L)
- 2163-0933
- PMC
- PMC5798208
- OpenAlex
- W1966771430
- Cited by
- 3
- References
- 9
- Citations by year
- 2026: 1 · 2022: 1 · 2018: 1
- FWCI
- 0.00
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Neurology Clinical Practice (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Yale University
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
- Health Sciences › Medicine › Neurology › Peripheral Neuropathies and Disorders
- Health Sciences › Health Professions › General Health Professions › Healthcare cost, quality, practices
- Keywords
- intravenous immunoglobulin, insurance coverage, health insurance policy, American Academy of Neurology guidelines, Guillain-Barré syndrome, chronic inflammatory demyelinating polyneuropathy, evidence-based recommendations, neurological disorders
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