PT INR Testing

[Jackie]

I am so disappointed to night. I have been working on getting a Hemosense Monitor for about 2 months. QAS had Faxed papers to my Doctor and I have been waiting for him to fill out the prescription form and send it back to them. I just received a call telling me that he will not approve it because they are unreliable, and it is not safe. I belong to Kaiser Permanete HMO so it is not just a fact for changing doctors. I have filed a grievance, maybe the borad will have a different opinon. Any sugestions?

Jackie

 

[Ross]

Jackie arm yourself with all of the evidence concerning other Medical Authorities studies of home testing and then dump it all on Kaiser. I'll try to find some of the things I have. We are talking about the top names in the game. Dr. Jack Ansell and a few others. Perhaps others will be along to give you ammo also.

Here is one to get you started. http://archinte.ama-assn.org/cgi/co...ffda7be0f79534c578c500c7&keytype2=tf_ipsecsha

Here is 316 article links-Every piece of info available and certainly more then enough to prove your point.
http://www.ncbi.nlm.nih.gov/entrez/...tractplus&dopt=pubmed_pubmed&from_uid=8512435

You may not be able to win an appeal with them, but you sure can prove them wrong!

 

[Guest]

The out 10 years ago, but they have all experience with Kaiser has not been good for home testing. The almost always insist on doing it in their lab.

The part about unreliable is an out-and-out lie. Any study done in the past 5 years has shown it to be safe and effective. There were some innacurate meters about 10 years ago, but they have all disappeared.

The real issue is that if Kaiser supplied meters for all of its patients on warfarin (about 7,000 in Denver alone) they would go broke.

 

[Jackie]

PT INR Testing

Thank you for your reply. I would appreciate any infor that you have. I am ready for a fight. I think the cardiolgy department at Kaiser is out the give me a heart attach. This is the second time I have not been happy with the Dept. I really like the surgen, but, I don't get too see him anymore, his work is compete. I had my Aortic Valve replaced in April.

 

[Guest]

QAS specializes in the meters, I don't. They should have that info or be able to direct you to someone at Hemosense who doies.

 

[Jackie]

PT INR Testing

I am not asking Kaiser to Pay, I was told that Medicare would pay to the Monitor and testing strips for a patient with a mechancal valve. That"s Me.
Jackie

 

[Guest]

Check Kaiser's relationship with Medicare. My guess is that they have a contract with Medicare to provide for your care. Therefore, Medicare would not approve this since Kaiser is responsible for you.

 

[Ross]

Check Kaiser's relationship with Medicare. My guess is that they have a contract with Medicare to provide for your care. Therefore, Medicare would not approve this since Kaiser is responsible for you.

On the same token, if they do contract with Medicare, by law they have to offer the same level of service offered to regular medicare receipients. Now this would be worth fighting for then.

 

[Jackie]

PT INR Testing

Thank you Ross, I am going to try everything I can to get this through. I now Kaiser does approve of the Hemosense because the Anti Corgulation Clinic told me that the Hemosense was the monitor they recommended. I was told that I would have to come to the lab every 10 weeks to have my blood checked and if the readings were to low or to high I would also have to come in for them to check. That was OK with me. I also know that when the Home nurse came this is what she used. In five months my readings have been either very hight or very low, only two times did they say it was OK. I am so tried of running back and forth to the lab. I am on my way this morning.

Jacke:

 

[Ross]

Jackie he hasn't been through here yet, but you might give Hemosense-Brendan a PM and see if he can't help you in some way also. He may have some extremely convincing literature you can use. I'm moving this to the Home Monitoring forum for him to see also.

 

[Marty]

Kaiser Anticoagulation?

Kaiser Anticoagulation?

I am so disappointed to night. I have been working on getting a Hemosense Monitor for about 2 months. QAS had Faxed papers to my Doctor and I have been waiting for him to fill out the prescription form and send it back to them. I just received a call telling me that he will not approve it because they are unreliable, and it is not safe. I belong to Kaiser Permanete HMO so it is not just a fact for changing doctors. I have filed a grievance, maybe the borad will have a different opinon. Any sugestions?

Jackie

After I retired from private practise radiology 10 years ago I began work for Kaiser Falls Church Virginia. Our anticoagulation is managed by two PhD pharmacists. The patients need to go to a Kaiser lab for a vein stick. The system seems to work for Kaiser. I've not come across any unhappy patients. As Al says they cannot afford to buy monitors for everyone that wishes to self test. The person that told you they don't allow selftesting because the monitors are inaccurate is passing out inaccurate information. Our lab here at Falls Church did consider buying finger stick monitors for their work ( not for patients)but decided the big vein stick monitors were more accurate and more consistent. I discussed this with the lab chief at that time and we agreed to disagree.

 

[Jackie]

PT/INR Testin

PT/INR Testin

Marty, I don't think you understand. It is the Cardiologist that maintains that the monitors are not reliable. If I could just get the perscription I would figure how to pay for it. However, Medicare will pay for patients with mechanical valves, not everyone on Coumadin.

Jackie

 

[Ross]

Jackie you may never persuade this Cardiologist otherwise. Is it possible to find a new Cardio sympathetic to your cause? How about your primary care physician?

Only reason I say this is, I went through it with my PCP and he also sited unreliability and would not budge no matter what I handed him. He still won't to this day! I quit asking and ask my Cardio and got the prescription no problem. My machine is as accurate as it gets. When I had to go to the hospital 3 weeks ago, I tested before I left and had a 3.0. The hospital lab got 3.3. I'm sure if I tested again, I could have come up with that number too. They are accurate no matter what they try to tell you.

 

[Marty]

Marty, I don't think you understand. It is the Cardiologist that maintains that the monitors are not reliable. If I could just get the perscription I would figure how to pay for it. However, Medicare will pay for patients with mechanical valves, not everyone on Coumadin.

Jackie

I didn't understand. I can't imagine such an ignorant cardiologist. My cardiologist told me about Coaguchek at my first visit to his office two weeks post op and gave me a prescription. I've since helped his patients learn how to self test and then self dose.If this person is so behind the curve on this issue he may be dangerous in other areas. I'd find someone else.

 

[Karlynn]

If this person is so behind the curve on this issue he may be dangerous in other areas. I'd find someone else.

This is my thought as well. Hasn't taken the time to bring himself up to date on current technology and information. Medicine is an evolving art/science and you want a doctor that is willing to evolve.

 

[Guest]

I have done well in excess of 50,000 tests using Coagu-Chek & CoaguChek-S. I'll put my outcomes up against any system in the world. A much more serious problem than accuracy of the meters is the goofy things people (even professionals) do with the results.

 

[HemoSense-Brendan]

This is my thought as well. Hasn't taken the time to bring himself up to date on current technology and information. Medicine is an evolving art/science and you want a doctor that is willing to evolve.

We are now where blood glucose was in the early 80's. Endocrinologists were saying, "There's NO WAY I'll let my patient self-test!" Then, over time, they slowly become knowledgeable on the technology and see the benefits in patient health. However, they still say "NO WAY will my patient inject their own insulin!" Then more years pass and they learn more and start to feel comfortable with self management.

 

[Ross]

We are now where blood glucose was in the early 80's. Endocrinologists were saying, "There's NO WAY I'll let my patient self-test!" Then, over time, they slowly become knowledgeable on the technology and see the benefits in patient health. However, they still say "NO WAY will my patient inject their own insulin!" Then more years pass and they learn more and start to feel comfortable with self management.

But why do they have to be so Daggone slow in learning?

 

[Jackie]

Doing The Happy Dance

Doing The Happy Dance

I Am Sooooooooo Excited. I Just Received A Phone Call From My Pcp, He Has Faxed My Paper Work To Qas For The Hemosense Monitor. I Have Worked So Hard To Get Someone From Kaiser To Approve Ths. Now I Just Have To Wait For Qas To Get Their Paperwork Done. My Visit To The Lab Will Not Be Seem So Bad In The Morning.

Jackie

 

[RandyL]

I Am Sooooooooo Excited. I Just Received A Phone Call From My Pcp, He Has Faxed My Paper Work To Qas For The Hemosense Monitor. I Have Worked So Hard To Get Someone From Kaiser To Approve Ths. Now I Just Have To Wait For Qas To Get Their Paperwork Done. My Visit To The Lab Will Not Be Seem So Bad In The Morning.

Jackie

Fantastic! I am happy for you.