Home Testing since COVID?

[perrybucsdad]

Hi all, I used to self test and had been doing it since the early 2000's. I quite self testing though when INRatio no longer were selling testing supplies due to their recall (I believe that is still in effect). When that happened I started to go to a Coumadin clinic. I've been fine with that, but when COVID hit, it became problematic to get appointments. At my last visit to my cardiologist, he was a little upset that I had not seen the clinic for over a month, and part of this was my fault as I had gotten sick (not covid though) and took longer to get my appointment reset. He said I should look into home testing again as things have changed since COVID and I should start with the Coumadin Clinic.

Can someone tell me how hard/easy it is to get approved for self testing now-days? I recall when I initially was approved it was a gut wrenching process to get approved. I also recall that I had to pay for all the supplies out of pocket. Has it gotten any easier?

I know I have seen people here talking about getting a tester off e-bay, and the same for testing supplies, but I have concerns with that (does the tester actually work, and with the strips, do I get 24 with them expiring in a month, etc.).

Anyhow, just curious on what would be a good option. I really don't mind going to the clinic (and there is no cost out of pocket for me) but not being able to test when I am sick, or change meds for something, etc is scary at time.

Thanks!

 

[perrybucsdad]

I'm really looking for some help if anyone can provide it.

I did find out my provider uses the Philips BioTel service, which I believe uses the Coagucheck Vantus system. I also was told that they have been unable to get my insurance in the past to pay for it. I believe the vantus unit costs about $700-800 but I'm not sure of what the supplies cost, and if I have to pay anything when it sends to results to BioTel which then sends them to my doctors. If anyone has any experience with this, I'd appreciate hearing. I'm considering paying out of pocket for the unit and supplies but they would have me test twice a month do knowing the cost of the supplies and how the cost of the service works would be helpful.

 

[MdaPA]

I believe the vantus unit costs about $700-800 but I'm not sure of what the supplies cost, and if I have to pay anything when it sends to results to BioTel which then sends them to my doctors. If anyone has any experience with this, I'd appreciate hearing.

The Philips BioTel service includes renting you a device, training, periodically sending you supplies along with technical support. You will also get notified if there is a recall which has happened. They also require you to call in your results for compliance reasons which they then in-turn relay to your Dr./clinic.

I'm considering paying out of pocket for the unit and supplies but they would have me test twice a month do knowing the cost of the supplies and how the cost of the service works would be helpful.

Philips BioTel service includes renting you the testing unit/device and sending you the supplies (test strips, lancets, lancet device) so not sure why you would pay out-of-pocket for this if their service includes it. If you want to pay out-of-pocket, then skip the service all together and call your Dr/clinic directly with the results.

 

[perrybucsdad]

Thanks for the reply. Okay, the nurse at my doctors office made it sound like I have to pay upfront for the device. Any idea what the rental cost is per month?

 

[RAS]

They bill every 4th test you report. The cost depends on your insurance plan.
The device and supplies are not an "a la carte" charge. It is all bundled.

They send more supplies out than I need for my every 2 weeks testing. So I test more frequently than I report.
Reporting results is via a webpage, mobile BT app, or phone call.


Ask both your insurer and Philips Biotel for the cost. If your insurance does not cover Biotel ask them what INR services they do cover. There is at least one other provider I'm aware of.

 

[Chuck C]

I know I have seen people here talking about getting a tester off e-bay, and the same for testing supplies, but I have concerns with that (does the tester actually work, and with the strips, do I get 24 with them expiring in a month, etc.).

Personally, I have purchased two Coaguchek xs devices on Ebay. I have tested against the lab and the accuracy has been spot on.
Per your question regarding test strips, as to whether the strips you buy expire within a month. This has not been my expierience. I have purchased strips on Ebay 3x and made sure that I did so from a seller with good ratings and reviews. Each time the strips had more than 12 months remaining before the expiration date. See photo below of the test strips which I ordered a month ago and expire November 30, 2022.

There is a lot of discussion on the recent linked thread below regarding the experience members have shared about buying on Ebay and the accuracy of their meters.

https://www.valvereplacement.org/threads/home-testing.888247/

 

[perrybucsdad]

Personally, I have purchased two Coaguchek xs devices on Ebay. I have tested against the lab and the accuracy has been spot on.
Per your question regarding test strips, as to whether the strips you buy expire within a month. This has not been my expierience. I have purchased strips on Ebay 3x and made sure that I did so from a seller with good ratings and reviews. Each time the strips had more than 12 months remaining before the expiration date. See photo below of the test strips which I ordered a month ago and expire November 30, 2022.

There is a lot of discussion on the recent linked thread below regarding the experience members have shared about buying on Ebay and the accuracy of their meters.

https://www.valvereplacement.org/threads/home-testing.888247/

I thought about doing that Chuck, but the issue is the coumadin clinic said I would still need to report them to Philips BioTel.

 

[Chuck C]

I thought about doing that Chuck, but the issue is the coumadin clinic said I would still need to report them to Philips BioTel.

Just curious what leverage the Coumadin Clinic has to dictate what you do with respect to your own device, how you obtain it and how you self test? How would they even know?
If you love your clinic, you could keep going to them and just test on your own more frequently for your own peace of mind.

 

[perrybucsdad]

That's actually an interesting thing to consider Chuck. One of the problems is that I work for the hospital system, and although the one I work for is ranked very highly for cardiac care, this makes it very hard at times to get in myself as last minute emergent things come up with my job and I have to miss my coumadin clinic appointment. What I was hoping was that my home testing I could come in once every three months or so. But, being able to test if I do miss my appointment is a great fallback. I just wish I could call the results into the Coumadin Clinic and they could tell me what to do if I am out of range.

Just curious... what is the cost you are seeing for testing supplies? Do you need to run a control test every so often on the unit or does it do something automagically? Sorry, I know with my glucose tester I use a control test every so often.

 

[RAS]

Just curious what leverage the Coumadin Clinic has to dictate what you do with respect to your own device

It's Bio-Tel's requirement that INR results be reported. The frequency (1 or 2 week schedule) is based on what your health care provider prescribes when signing up for the service. I arranged this with my cardiologist and requested he prescribe the 2 week testing schedule. So that is how often I report results to Bio-Tel, but I receive enough strips from them to test more often.

Whether it's a Coumadin clinic, Cardio, Primary Care does not matter. A patient can pick any one of their health care provider's who is willing to get this setup with Bio-Tel. The reporting requirement is the same in order to receive the service.

 

[Chuck C]

Just curious... what is the cost you are seeing for testing supplies? Do you need to run a control test every so often on the unit or does it do something automagically?

The first Coaguchek xs I bought on Ebay for $230. The next one I purchased for $49, which was missing a battery cover and the other small blue cover in the front, which were both easily and reasonably replaced when I contacted Roche. I get the test strips for $140, including taxes, for 24 strips, which comes to $5.83 per strip.

It runs its own quality control test each time you test.

From the Coaguchek xs manual:

"The Coaguchek xs System has built-in quality control functions in the meter and test strips. The meter automatically runs its own quality control test as part of every blood test.."

 

[perrybucsdad]

The next one I purchased for $49, which was missing a battery cover and the other small blue cover in the front, which were both easily and reasonably replaced when I contacted Roche

So how much did the battery door and blue cover cost?

 

[Christyleedh]

I really disliked using the INR monitoring service, which required that I call into the service with my results, and then the doctors office would call me later. It was very inefficient. They would also require testing the same day, every week, and they would call me continually until I reported the results. However, I would get off track because of a result out of range, which would shift my testing schedule to something different. It was as if they had no flexibility, and their reporting was delayed, by sometimes even a couple of days to my doctors office.

I now have my own monitor and purchase the test strips- $275 for 48 strips. I check at home twice a week and call my Coumadin clinic only when I’m outside of my range to discuss if I need to change my dose. I see the Coumadin clinic in person about once a month, and check my device against theirs every other month, and my numbers are always within a .2 difference. The only time my insurance is billed is if I go in person, or if I have call in to discuss my results.
I have tried without luck to get the strips covered under insurance. I had my doctor write a prescription for the strips, and the local hospital pharmacy has them available for me to purchase, but my insurance says they are a “durable medical good” and cannot be obtained from a pharmacy under my prescription plan, and because the pharmacy is not licensed as a durable medical goods supplier, the insurance company won’t allow me to purchase it from the pharmacy and get reimbursed. (The pharmacy price is also double what I can find online).

I cannot find the test strips anywhere from a licensed durable goods supplier, because it is my understanding that Roache does not allow the device to be sold for home use- unless you sign up for a monitoring service. It is a purposeful catch 22- designed to require us to use the monitoring services, which most of us don’t need

 

[perrybucsdad]

I think the one item that concerns me are the test strips. Getting them of ebay, I dunno, I have worries they may have been stored improperly and could that cause the results to be inaccurate?

 

[Chuck C]

I think the one item that concerns me are the test strips. Getting them of ebay, I dunno, I have worries they may have been stored improperly and could that cause the results to be inaccurate?

As I shared previously, I have purchased all my strips on EBay. My own testing results have always been spot on with my lab results
If you get to that point, I’d be happy to send you the link for the EBAY seller which I buy from.

 

[tom in MO]

Hi all, I used to self test and had been doing it since the early 2000's. I quite self testing though when INRatio no longer were selling testing supplies due to their recall (I believe that is still in effect). When that happened I started to go to a Coumadin clinic. I've been fine with that, but when COVID hit, it became problematic to get appointments. At my last visit to my cardiologist, he was a little upset that I had not seen the clinic for over a month, and part of this was my fault as I had gotten sick (not covid though) and took longer to get my appointment reset. He said I should look into home testing again as things have changed since COVID and I should start with the Coumadin Clinic.

Can someone tell me how hard/easy it is to get approved for self testing now-days? I recall when I initially was approved it was a gut wrenching process to get approved. I also recall that I had to pay for all the supplies out of pocket. Has it gotten any easier?

I know I have seen people here talking about getting a tester off e-bay, and the same for testing supplies, but I have concerns with that (does the tester actually work, and with the strips, do I get 24 with them expiring in a month, etc.).

Anyhow, just curious on what would be a good option. I really don't mind going to the clinic (and there is no cost out of pocket for me) but not being able to test when I am sick, or change meds for something, etc is scary at time.

Thanks!

My cardiologist's nurse set everything up for me. She worked with my insurance company and the provider. The provider contacted me. My provider gives me the meter for free but I pay for supplies. I live in the US and have private insurance. Some buy meters and supplies off the internet. For me, I'm not betting my life on a used meter, with unknown history, bought on ebay.

 

[perrybucsdad]

My cardiologist's nurse set everything up for me. She worked with my insurance company and the provider. The provider contacted me. My provider gives me the meter for free but I pay for supplies. I live in the US and have private insurance. Some buy meters and supplies off the internet. For me, I'm not betting my life on a used meter, with unknown history, bought on ebay.

I'm glad your insurance covers that Tom... unfortunatly, my insurance refuses to cover it. Hopefully someday that will change, but for now, I can go monthly to the coumadin clinic, or when my work forces me to miss my appointment, I may go longer than I should between INR screenings. This is unacceptable to me. I don't want to bet my life on something that is unknown either, but I sure don't want to make my testing longer than needed too. Neither option is good.

 

[Beach77]

I'm go to a Coumadin clinic about every 6 weeks and I bought a meter/strips off ebay. The clinic gives me an extra piece of mind, along with the weekly testing I do for myself. I did tell the clinic I bought the meter and it has helped a few times, when I've had to call about something. I can give them my current reading They do not want me to self dose, which I'm okay with. If I have concerns, I can always call and go in. My insurance (Medicare) would pay for service but the clinic wouldn't follow me, if I went that way. My GP would take over the dosing. The cost isn't too much, about what Chuck said. I'm okay with the out of pocket expense, it gives me piece of mind testing weekly, then a lab draw at 6 weeks.

 

[MdaPA]

At my last visit to my cardiologist, he was a little upset that I had not seen the clinic for over a month, and part of this was my fault as I had gotten sick (not covid though) and took longer to get my appointment reset. He said I should look into home testing again as things have changed since COVID and I should start with the Coumadin Clinic.

perrybucsdad,
If your Cardio said you should look into home testing (assuming he means BioTel's home monitoring service), why is he saying you should start with the Coumadin Clinic? I don't understand what the Coumadin Clinic has to do with home testing.

Can someone tell me how hard/easy it is to get approved for self testing now-days? I recall when I initially was approved it was a gut wrenching process to get approved. I also recall that I had to pay for all the supplies out of pocket. Has it gotten any easier?

If you are interested in the BioTel Heart home-monitoring service, your Cardio needs to send a script to them with your insurance information. If your insurance covers this service and you are approved, then BioTel will contact you regarding sending you a testing device (to rent) along with supplies and training. You should then not have to pay for supplies out of pocket. BioTel will bill your insurance company and then you normally would pay your applicable co-payment/co-insurance after your deductible.

I did find out my provider uses the Philips BioTel service, which I believe uses the Coagucheck Vantus system. I also was told that they have been unable to get my insurance in the past to pay for it.

Not sure what you mean by "my provider uses the Philips BioTel service"? You, the patient, would subscribe to this service, you would call your testing results to them, and then they would contact your Cardio with the results. BioTel requires you call them instead of your Cardio so they can make sure you are complying and testing on schedule.

Perhaps you meant the your Cardio does in-office testing with a Coagucheck Vantus machine but your insurance doesn't cover them testing your INR with this?

 

[perrybucsdad]

If your Cardio said you should look into home testing (assuming he means BioTel's home monitoring service), why is he saying you should start with the Coumadin Clinic? I don't understand what the Coumadin Clinic has to do with home testing.

What he meant is I shoudl talk with the people at the Coumadin Clinic as they coordinate using the home testing with BioTel.

If you are interested in the BioTel Heart home-monitoring service, your Cardio needs to send a script to them with your insurance information. If your insurance covers this service and you are approved, then BioTel will contact you regarding sending you a testing device (to rent) along with supplies and training. You should then not have to pay for supplies out of pocket. BioTel will bill your insurance company and then you normally would pay your applicable co-payment/co-insurance after your deductible.

I get all that, but as I stated above, my insurance does not cover the service,