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DecisionDx-Melanoma (Castle test): When is it necessary?
After having melanoma removed from my scalp in June, I had my first checkup today with my original dermatologist that found it. He mentioned that I might want to have a Castle test done. From reading about it on the company's website, it almost sounds as if it is for people who have *not* had a SNB and are trying to decide. I *did* have them and all came out clear.
It sounds like the Castle test does not really give much actionable information for someone like me. I am going to reach out to my surgeon (at Moffitt Cancer Center in Tampa) to see what they say about it. So far they have said I am clear and only need to have quarterly checkups with my dermatologist like anyone else.
I would appreciate any comments or experiences....
Thanks,
Mitch
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The bill shouldn't exist in the first place. I'm contesting the entire test.
Castle NEVER bills the patient. If insurance doesn't pay, Castle eats the bill. I work at a Skin Cancer clinic and order these tests often. It helps determine how bad the Melanoma is and risk of reoccurrence even if the SNB is clear; we still like to know how "high risk" you are.
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1 ReactionMitch, we order the test on any Melanoma whose Breslow depth is above .6, regardless of SLB results. It helps determine how "high risk" you are for reoccurrence. We work very closely with Oncology and Castle never, ever bills the patient. If insurance does not pay; Castle eats the bill. It's a free test, for you - and there's no reason not to get it.
Ginger, what was your Breslow depth? You can request the test, if it was above .6 - it helps access the risk of reoccurence. But, some offices do not know about it or think it's useless. It's helped many of our patients.
This is the "guidelines" we use when ordering Castle. It gives insight on how it helps your providers with your particular Melanoma case. If you've had 2 Melanomas within 2 months, you're at a higher risk and just because one SLB came back negative, doesn't mean it's not in another lymph node... or another Melanoma could potentially be spreading to another lymph node soon.
Again, the test is free for you & if insurance doesn't pay... Castle eats the bill. All it does it help your Dermatologist/Oncologist know your future risk.
Castle Bioscience Melanoma Study (Castle-Bioscience-Melanoma-Study.pdf)
I finally got in touch with the Dermatology office - they told me that Castle should never have even submitted the bill to my insurance company, that Castle and the Dr. have their contracted agreement and anything I would have to pay comes out of my Dr.'s agreement with my insurance company and my co-pay. (basically an all-inclusive fee). But Castle never sent me a bill, and it still shows up on my insurance claim history as submitted and denied, and that my out of pocket cost is now $8500 more than it was.
Castle always submits bills to insurance, but will never bill or expect you to pay if/when insurance denies. The doctor's office may not fully understand how Castle bills/gets paid. There's not technically a "contracted agreement" between Castle and any doctor's office. They have a rep that comes in that if you order, you order and if you don't - you don't. They don't even really offer contracts, to my knowledge. You can call Castle directly and get more information from them at 866-788-9007, option 3. But, you will never receive a bill from them regardless.
The same exact thing just happened to my husband. Did you have any luck getting them to cancel the $8500 bill? We didn’t authorize this test! How can they do this?
See my last response in the thread. I never received a bill, it didn't actually exist.
I'm not convinced about Castle Testing. I had it performed back in early 2020 on an amelanotic lesion that was melanoma requiring surgery. The test results came back as 1A: low chance of recurrence/metastasis. Well, four years later and it metastasized, which is why I'm here now. I think because it was done so soon after approval I was never billed for it, but repeatedly asked if I wanted to give a charitable contribution to the company.