Any ideas on how to get help on getting home kit?

[mharris]

I have had my new valve for 6 yrs. and the day after my 6 yr anniversary I threw a blood clot into the main artery and it caused a heart attack. I am only 35yrs old with 4 kids. When I had my first surgery our 4th baby was 11 days old and they repaired the valve then 3 weeks later I went back into heart failure so they replaced it then. Our baby was 5 wks old for the 2nd surgery. Just when I thought life was great I hit 6 yr mark the next day this happens. We have Blue cross Blue shield and I have tried to get home kit before but there were no preferred providers that new what it was or could get me one. So, we would have to pay the higher percentage. Does anyone know if there is a way get help with getting a home kit so this does not happen again? My inr had been great for the last 6-7months but when I got to the hospital and they checked it, it was 2.0. I have not changed any eating habits the only thing is spring time which has never been this bad before but camping, gardening, and kids sports increase my exercise that is the only thing different right now. Any thoughts on how to go about getting a kit would be greatly appreciated. Thanks..

 

[Ross]

BCBS can be a real pain in the butt. Fact of the matter is, there are only a handful of providers to choose from. It's up to them to find one to deal with, not you. My suggestion is to try to get one through QAS. They take care of the insurance end of things and will be able to help you more then you can help yourself.

http://www.ptinr.com/data/templates/article.aspx?a=669&z=35

 

[terodac]

QAS wants $2500 for a INR machine, You can order it on line from $500 to $1500, if your doctor writes you the script then they should honor it! I had to pay out of pocket ordered mine on line $700 plus supplies. Waiting for it now, I pray I did not get ripped off inrtest.com is who I ordered it from. They seemed like a good company. I will surely let everyone know!

 

[Philip B]

INR Monitor

INR Monitor

The first step is to visit with your cardiologist about your desire to do the home monitoring thing. If your cardio doc agrees with the direction you want to go with this, get a perscription for the monitoring machine and the supplies you'll need to home test.

Locating a medical equipment supplier who can sell you a machine and the necessary testing supplies isn't difficult. Often, you'll see recommendations from other members to use QAS and for good reason. Members often recommend suppliers whom they've had good success with. I purchased my monitoring machine from QAS, but there are other reputable, legitimate suppliers out there. Prices for monitors vary. The monitor that would've cost my insurance company $2,500.00 cost me around $1,200.00. It's interesting see how prices tend to change depending upon who's paying.

Dealing with insurance companies to get them to purchase an INR monitor can be an adventure if your insurance company is disagreeable. Mine eventually reimbursed me for my monitor, but the fight lasted more than six months. My insurance company still refuses to pay for testing supplies.

Good luck!

-Philip

 

[ALCapshaw2]

A while ago, QAS sent out a notice that they had reached an agreement with BCBS. Unfortunately, (at least at the time), BCBS coverage was on a State by State Basis and there was NO continuity (or cooperation) across state lines.

As you see, some of our members Buy their INR meter directly from QAS or other provider, often at a substantial discount, and they haggle with their insurance company.

A "case worker" (from the Insurance Company) can often be of great help in "greasing the skids", especially if your case worker has a clue about anti-coagulation and why it is needed for Valve Patients.

Sometimes, even when BCBS finally decides to pay for the instrument, they decline payment for the Test Strips because they are seen as Durable Medical Equipment and can fall under separate guidelines. BCBS can be a REAL PAIN to deal with on this issue. Some members have been round and round even trying to find someone in the insurance company who even knows what anticoagulation is, much less why it is needed for Valve Patients.

GOOD LUCK !

p.s. How close are you to being on Medicare?
Medicare endorses and approves Home Testing for Valve Patients. They have a public statement to this effect which some members have used to argue their cases.

 

[Blanche]

Medicare Statement

Medicare Statement

Here is the Medicare Statement mentioned by Al Capshaw.

https://www.cms.hhs.gov/mcd/viewdecisionmemo.asp?from2=viewdecisionmemo.asp&id=72&

Sometimes doctors resist home testing by their patients. Some people here have used this Medicare document to convince their doctors that home testing is valid and reliable and suitable for use.

Regards,

Blanche

 

[COLLEEN S]

Wow, I hope you are able to get one. I am right as we speak going thru QAS who contracted me out to Edge Medical. My insurance is blue something or other.

 

[westie]

fast tracked

fast tracked

.
gosh, i would have thought you would have been fast tracked for home testing after your heart attack.

hope you get a home tester soon, untill then i guess your inr is a constant concern.

what sort of valve did you have implanted?

good luck

westie

 

[terodac]

I got my machine in five days from inrtest.com, it had 24 free strips and a bunch of lancents. I have finally learned how to work it now and I love it. I paid right at $700 for it sure beats $2500 this company is in Australia but seems to be a honest company! I sure saved a lot of money!

 

[Taysgrama]

I have Blue Cross/Blue Shield and because the monitor is considered Durable Medical Equipment, I contacted QAS and they sent the required paperwork to my cardio first, then to my insurance company. BCBS paid 100% for my monitor and they pay 80% for my testing supplies. I just got 24 test strips and lancets for $32, out of my pocket. QAS contacted my insurance company for approval and payment for my testing supplies. Once they were paid, QAS called me with my total and I paid it. Supplies were delivered 2 days later via UPS 2nd day air. Not sure how different your policy is, but when I called BCBS before I called QAS, the reps didn't have a clue what the monitor was for. They assumed that I was questioning diabetic testing supplies and equipment. It is easier to let QAS deal with the insurance company then to try to explain what it is to an unqualified lay person. Good luck!!!