INRatio issues

[Karlynn]

Well, I finally got the answer from Raytel. Even though BC/BS will cover the purchase of an INRatio machine - Raytel will not go through with it because apparently they have not been getting paid by BC/BS for machine purchases - even for those who's insurance qualifies them. Raytel will do the "rental" program where they loan me a machine and send supplies and I test weekly and call it in to them. W/ my insurance, it would run me about $4 a test. I'm pretty certain I don't want to do that. After 3 years of going it on my own, I don't think I'd be thrilled about having to be accountable to a company each week.

I really wished they would have told me about their issues with BC/BS earlier, I would have pursued the repair of my ProTime, now on 12/27 it's too late to get that going, or get another Rx from my card and pursue a purchase of the INRatio through another company.

I'll have to wait and see what our 2006 benefits hold with BS/BC. I had been told they may be changing benefits, but I don't know to what yet.

 

[Natanni]

Raytel

Raytel

Hi Karlynn

We purchased Nathan's through QAS, and I used my credit card and they sent it within 3 days. I submitted the itemized receipt to BCBS of MN and they reimbursed us with a check. As for now, we are just ordering Nathan's test strips and paying out of pocket. Working on having them run through QAS, but I think something is changing now on how they are handling test strips/insurance. No chance in getting another RX quick-like?

 

[Ross]

Karlynn I think you should get on the phone now, take notes of who you talked to and file an appeal or claim for further reconsideration. At least make it official with the time clock running out, then if it all goes sour, you'll have just cause to pursue the Protime.

 

[Karlynn]

I'm also thinking that the loaner program may possibly be a more lucrative deal for the company, and possibly easier to get reimbursement for. I tried calling both Raytel and BC/BS, but it was past business hours by the time I received the voicemail message.

 

[JCDavis81]

Hey Karlynn,

I'm doing the Raytel rental program thingy. I have CIGNA, not BCBS, but they seemed more willing to cover the rental agreement than the purchase of the machine itself. I don't know why, it doesn't seem like it makes too much sense for them.

Anyway, I've been self testing for three weeks and calling in my levels really is pretty easy. They have an automated system and you just type in the number, then Raytel reports whatever it was directly to your doctor. So far, the raytel nurses themselves have never altered my coumadin -- they just report the info to my doc and he's been the on that has increased/decreased my dose.

Good luck with it.

Joe

 

[Karlynn]

Okay - I'm really ticked off now. Just spoke with my insurance company. They have no record of Raytel contacting them regarding a purchase OR a lease program. It's my guess that Raytel knew that BC/BS would cover the lease program and just decided to give me that option without contacting the ins. co. Now I'm busy scrambling (with the assistance of the BC/BS rep) to get the Supply and Dx codes to see if I even need an Rx to purchase the machine. The rep told me that they don't require Rx's for a lot of DME (Durable Medical Equipment) purchases, but she'd be able to tell me when she saw the exact codes.

Why couldn't Raytel have just done this when I initially contacted them?

The pleasant side of all this is that the BC/BS reps have been so helpful. Very unlike insurance companies!

2.5 days to get this taken care of if I can.

 

[Karlynn]

Just received a call back from the BC/BS rep. Raytel won't sell me a machine, because they don't sell machines they just do the lease program. WHY didn't they tell me that a month ago when I first called??? I already know the answer to that.

 

[Karlynn]

Called QAS - they're going to try and expedite a purchase for me. But also found out that my benefit for DME is the same next year, so all hope is not lost.

 

[geebee]

Good news - I hope you get your INRatio as it is a great monitor.

 

[Georgia]

Geesh, Karlynn - this sounds like the black hole of medical equipment. Or dme hell. Honestly - you just couldn't make this up.

Good luck.

 

[Granbonny]

Karlynn

Karlynn

I was wondering..what happened to your Protime?Mine is still working good after 3 years and 8 months. NEVER a problem. Was it NOT repairable?.......I'm in the same boat now..I am on Medicare and they will pay for my supplies..IF I test weekly and call in results...No way..so, I'll look around and see where I can get the cheapest supplies. QAS or Raytel...and pay for them ..myself.I have a good thing going with my Cardio's clinical Nurse after all these years.I don't want anyone between ..me and her. I call her once a month..she calls me back the same day.Same doseage..never a change. ...Joe..just a question for you...You will get into range soon. do you really want to test weekly..forever?...Remember, if you are traveling, ect. have to haul that machine around with you.. ..Bad enough to have to remember to take my coumadin everyday...Worse, if I had to haul it around with me on trips, ect. ....just to call in my INR..Weekly...If your insurance will not pay for your own machine..maybe you can start saving and asking friends, ect.for money gifts on your birthday, xmas ( Like my daughter does)..when she wants something special. ..this year, it was to have her teeth whiten.. and she got the money at xmas....bonnie

 

[gijanet]

Sorry.........I've been sick thanks to my Katie!

Sorry.........I've been sick thanks to my Katie!

and didn't see this...........haven't been on much at all. But just wanted to let you know that we have BC/Bull sh**, too. Went through QAS, got all of our ducks in a row, or so we thought. Had to send QAS a copay of $200 something (which I am still trying to figure out that one as we have TRicare, too, as a backup, but they never pay anything anyway). Supposedly everything was a go. We got our machine. Then right before Christmas.............Merry Christmas to us!! we got a statement from BS saying that the payment for the machine was denied and that they needed more info..............ARGHHHH!!!! We have spent literallly hours on the phone to both QAS and BS explaining everything to everyone, it seems, prior to our being "approved"..............and now this! Don's gonna tackle this next week and figure out what is up. I'm sure some reviewer somewhere higher up at BS is questioning a five year old's need for an INR machine............duh! well, let's see. I have a child prodigy who has already conducted all of the medical experiments at our local Geeks 'R Us toy store, so we are looking for something more realistic....................ARGH!
Don's gonna follow up on it next week. Will let you know how the next episode of "As the Blood Clots.........or Does IT?" turns out...................sigh!

Hugs. J.

 

[Karlynn]

Oh my Janet, I don't like reading that. So far BC/Bs** has been very cooperative, it was Raytel that didn't ever pursue coverage. BC/BS keeps telling me I'm covered. We'll see what QAS comes up with when BC communicates with them. They got me my last machine, but I had a different insurance provider then.

I have a feeling that it will not end up being as easey as the BC/BS makes it sound. (You're covered at 90% for DME, you should be able to get one, but we won't know until we get the specific supply and Dx codes.)