I have just recently, as of 01/07/11 started taking coumadin for a mechanical valve. I am interested in doing home therapy after my 3 months. My cardiologist is fine with this.he does not have any company he reccomends. I am asking for advise on what is the best company to work with? How does this work. How did you get a dr to agree to let you do home testing and regulate your own inr?. I would like to adventually get to that point.
Questions
- Thread starter KLAMDUP
- Start date
Help Support Valve Replacement Forums:
There have been many threads on this topic. May I suggest that you look through the anti-coug threads, you may find the answers your looking for. I for one cannot answer; I live in Canada and our system works differently than yours.
Oh yea, being the weekend it can be a little slow around here, but someone will be around to point you in the right direction if you can't find your answers.
Oh yea, being the weekend it can be a little slow around here, but someone will be around to point you in the right direction if you can't find your answers.
Klamdup:
Several vendors sell or rent PT/INR home monitors.
I bought both of mine through QAS, which has since been acquired by another company. With my first machine, bought in 2003, QAS handled all paperwork, including contacting the insurance carrier I had at that time, which covered it 100%.
When I decided to get a smaller unit nearly 3 years ago, I again bought mine from QAS -- but I paid cash upfront to save $1,000 on the price. My current insurance carrier covers durable medical equipment at 80% -- but what you aren't told is that it's 80% of usual charge. (Hellooooooooooooo! There's no "usual" charge for INR testers!) I filed a claim for a little over $1600, which included a wall charger and something else (can't remember) and got a check for almost $1,000.
Some insurance carriers may require you to rent the unit first, then allow you to purchase it later on. Or it may be a straight rental. Or it may be a purchase. You will need to check your EOB and details. You will probably find that no insurance employee knows what an INR tester is.
Arm yourself first with documentation from your carrier. My carrier is Aetna, and I found a document online stating that it covers home testers for people with mechanical valves (some other situations are considered "experimental," "unnecessary," a "convenience" or a similar term). When I submitted my claim, I mailed a copy of that document, along with information about the Hemosense INRatio I had bought and copies of studies showing that warfarin patients who home-test stay in range more than others.
I had about 8-9 years' worth of Coumadin diaries (from Coumadin's mfr) that my PCP's office gave me. Am nearly out of those. Have since found a file at Hemosense's website that I will begin using to log my INRs:
http://hemosense.com/docs/0200233_Pa...ricRevAweb.pdf
I've made about 30 copies of it and inserted them into a ringbinder that I keep copies of articles on warfarin. Years ago, when Al Lodwick (a pharmacist and CACP who ran an anticoagulation clinic at a hospital in Colorado) had a great website with loads of info about warfarin. I bought a bound booklet of lots of those articles, so I keep that in the ringbinder, too.
I suggest that anyone on longterm anticoagulation therapy copy articles about warfarin dosing, what to do for various procedures, etc. You never know when you may need to share that information with your doctors. A doctor has many patients to care for; you have only yourself and therefore have more time to research your own situation.
My PCP writes my warfarin RXes. I adjust my dosage, do not have to call in my INRs to him. I've been pretty stable on 5X4 + 5.5X3 for about a year, maybe longer. I've had a few INRs a little low, a few a little high over the last year. Two weeks ago my INR was 2.4, down from 3.4 the week before. I decided not to up my dosage and retested yesterday and it was 3.0.
Good luck with your search for a monitor and a vendor! You'll love having your own machine!!
Several vendors sell or rent PT/INR home monitors.
I bought both of mine through QAS, which has since been acquired by another company. With my first machine, bought in 2003, QAS handled all paperwork, including contacting the insurance carrier I had at that time, which covered it 100%.
When I decided to get a smaller unit nearly 3 years ago, I again bought mine from QAS -- but I paid cash upfront to save $1,000 on the price. My current insurance carrier covers durable medical equipment at 80% -- but what you aren't told is that it's 80% of usual charge. (Hellooooooooooooo! There's no "usual" charge for INR testers!) I filed a claim for a little over $1600, which included a wall charger and something else (can't remember) and got a check for almost $1,000.
Some insurance carriers may require you to rent the unit first, then allow you to purchase it later on. Or it may be a straight rental. Or it may be a purchase. You will need to check your EOB and details. You will probably find that no insurance employee knows what an INR tester is.
Arm yourself first with documentation from your carrier. My carrier is Aetna, and I found a document online stating that it covers home testers for people with mechanical valves (some other situations are considered "experimental," "unnecessary," a "convenience" or a similar term). When I submitted my claim, I mailed a copy of that document, along with information about the Hemosense INRatio I had bought and copies of studies showing that warfarin patients who home-test stay in range more than others.
I had about 8-9 years' worth of Coumadin diaries (from Coumadin's mfr) that my PCP's office gave me. Am nearly out of those. Have since found a file at Hemosense's website that I will begin using to log my INRs:
http://hemosense.com/docs/0200233_Pa...ricRevAweb.pdf
I've made about 30 copies of it and inserted them into a ringbinder that I keep copies of articles on warfarin. Years ago, when Al Lodwick (a pharmacist and CACP who ran an anticoagulation clinic at a hospital in Colorado) had a great website with loads of info about warfarin. I bought a bound booklet of lots of those articles, so I keep that in the ringbinder, too.
I suggest that anyone on longterm anticoagulation therapy copy articles about warfarin dosing, what to do for various procedures, etc. You never know when you may need to share that information with your doctors. A doctor has many patients to care for; you have only yourself and therefore have more time to research your own situation.
My PCP writes my warfarin RXes. I adjust my dosage, do not have to call in my INRs to him. I've been pretty stable on 5X4 + 5.5X3 for about a year, maybe longer. I've had a few INRs a little low, a few a little high over the last year. Two weeks ago my INR was 2.4, down from 3.4 the week before. I decided not to up my dosage and retested yesterday and it was 3.0.
Good luck with your search for a monitor and a vendor! You'll love having your own machine!!
ALCapshaw2
Well-known member
Alere Home Monitoring Products is the company that bought QAS.
Their contact information is:
70 S. Keller Road
Orlando FL 32810
800-298-4515
I believe this is the old QAS location.
Alere also has offices in California.
QAS (and presumably Alere) can help you in dealing with Doctors and Insurance Companies.
They usually ask you to get a prescription for a Home Test Monitor from you Physician and then they contact your insurance company.
They have some information available that may be of interest to your Physician regarding the benefits of Home Testing.
'AL Capshaw'
Their contact information is:
70 S. Keller Road
Orlando FL 32810
800-298-4515
I believe this is the old QAS location.
Alere also has offices in California.
QAS (and presumably Alere) can help you in dealing with Doctors and Insurance Companies.
They usually ask you to get a prescription for a Home Test Monitor from you Physician and then they contact your insurance company.
They have some information available that may be of interest to your Physician regarding the benefits of Home Testing.
'AL Capshaw'
KLAMDUP, I had to drop in yo say A HEARTFELT WELCOME TO OUR OHS FAMILY I am not on coumadin (one of the few) so I cant help but i see you are already getting suggestions and THAT is what THIS FORUM IS ALL ABOUT
Klamdup:
IF you have insurance, it may be easiest to work through a company - Philips and Alere are the two largest. You will probably have to decide whether to have the company work as supplier of meter and strips and contact your physician when you phone in results. This works well for some people - but there have been threads about how this approach drives up the cost of insurance and medical care (from what I recall, these companies charge much more than the actual supplies cost, and all they're basically doing is making sure you're reporting results and forwarding this information to your doctor).
It's more affordable for you to do your own testing without adding all the overhead that these services charge (from what I've read, at least).
There are many medical equipment providers who can sell you a meter, with a doctor's prescription, and these (and others) can also sell you the strips. If you do your own self-testing - and perhaps even self-management - you will probably save yourself money, and may even save the insurance company some of its costs.
For myself -- I have no insurance. I've been self-testing for about two years - and wish I could have done it for the 19+ that I've been taking warfarin. I bought my meters on eBay (I know many people won't buy anything - particularly medical equipment - on eBay, but my experience with meters and strips has been quite satisfactory). I have bought my strips from suppliers I found on the Internet - and in some cases, I had a doctor friend buy them for me (because some suppliers charge much less for the same strips to be used at a doctor's office than they would for a patient with a prescription), and I also got some strips on eBay. I'm currently using an InRatio -- I've compared results to other meters and trust the results.
I don't use an INR booklet - I've created a spreadsheet on my computer and record every test result. If I have a doctor who wants to confirm that I'm recording my self tests, and properly managing my dosage, I can provide - at this point - about 100 test results. (I very recently went through an odd dip in my results -- I usually take 49 mg/week - 7 mg/day - and stay in range. Last Thursday, I had a 1.6 - not real troubling to me - and upped my dose for one day to 10 mg. Three days later, I was back to 2.5. I'll probably stay at 52/week, taking 8 mg monday, wednesday, friday and 7 mg the rest, unless my INR goes too high.)
I think that it's great that you doctor supports self testing, and wish you luck in your search for an option (rent?, buy?, etc.) that works for you.
IF you have insurance, it may be easiest to work through a company - Philips and Alere are the two largest. You will probably have to decide whether to have the company work as supplier of meter and strips and contact your physician when you phone in results. This works well for some people - but there have been threads about how this approach drives up the cost of insurance and medical care (from what I recall, these companies charge much more than the actual supplies cost, and all they're basically doing is making sure you're reporting results and forwarding this information to your doctor).
It's more affordable for you to do your own testing without adding all the overhead that these services charge (from what I've read, at least).
There are many medical equipment providers who can sell you a meter, with a doctor's prescription, and these (and others) can also sell you the strips. If you do your own self-testing - and perhaps even self-management - you will probably save yourself money, and may even save the insurance company some of its costs.
For myself -- I have no insurance. I've been self-testing for about two years - and wish I could have done it for the 19+ that I've been taking warfarin. I bought my meters on eBay (I know many people won't buy anything - particularly medical equipment - on eBay, but my experience with meters and strips has been quite satisfactory). I have bought my strips from suppliers I found on the Internet - and in some cases, I had a doctor friend buy them for me (because some suppliers charge much less for the same strips to be used at a doctor's office than they would for a patient with a prescription), and I also got some strips on eBay. I'm currently using an InRatio -- I've compared results to other meters and trust the results.
I don't use an INR booklet - I've created a spreadsheet on my computer and record every test result. If I have a doctor who wants to confirm that I'm recording my self tests, and properly managing my dosage, I can provide - at this point - about 100 test results. (I very recently went through an odd dip in my results -- I usually take 49 mg/week - 7 mg/day - and stay in range. Last Thursday, I had a 1.6 - not real troubling to me - and upped my dose for one day to 10 mg. Three days later, I was back to 2.5. I'll probably stay at 52/week, taking 8 mg monday, wednesday, friday and 7 mg the rest, unless my INR goes too high.)
I think that it's great that you doctor supports self testing, and wish you luck in your search for an option (rent?, buy?, etc.) that works for you.
AgilityDog
Well-known member
Do watch out if you have a large insurance deductible. Philips wanted me to pay a co-pay of $248 PER MONTH, FOREVER for the rental of the Inratio meter and their monitoring service. Insurer wanted me to use the monitoring service. NO THANKS. With a $3,000 annual deductible, I'd have been paying out the nose for a meter that wasn't mine, for the privilege of having them fax to my doctor the same information I picked up the phone and called in to my doctor. DUH. No brainer. Now my doctor lets me self-manage.
I bought my own meter for $750 and pay about $250 for 48 strips. I haven't bothered with trying to get UHC to reimburse me for my strips or meter. I'm still trying to get UHC to pay the pathology/laboratory bill from my last surgery in August!
I bought my own meter for $750 and pay about $250 for 48 strips. I haven't bothered with trying to get UHC to reimburse me for my strips or meter. I'm still trying to get UHC to pay the pathology/laboratory bill from my last surgery in August!
KLAMDUP,
I had my avr in july 2010. I spent several weeks going to my docs office to get my inr done there, while i researched a place that would work with my insurance so that i could get my own meter. it only made sense to me to have the insurace "purchase" me a meter and not rent or lease one in which case i would have a large copay every month.
My insurance wasnt contracted with any of the larger companys anyways(Alere or Phillips). But i finally tracked down a supplier of Durable Medical Equipment(DME) that worked with my insurance. after more time waiting i finally got in touch with someone that knew what they were doing there!
Sterling Medical is who my meter came from, which they order from Alere.
The nice thing is that this is my meter and that i am not leasing it from Alere.
I still dont know what it cost me or my insurance for the meter. i recieved it in early Nov.
But if you do want to talk to someone knowalgeable in meters then call this guy:
Paul at Sterling Medical
1-800-216-5500
ext 68145
he seemed very qualified compared to everyone else that had no clue what an inr was.
Good luck and ask us anything... we all will try to help!
I had my avr in july 2010. I spent several weeks going to my docs office to get my inr done there, while i researched a place that would work with my insurance so that i could get my own meter. it only made sense to me to have the insurace "purchase" me a meter and not rent or lease one in which case i would have a large copay every month.
My insurance wasnt contracted with any of the larger companys anyways(Alere or Phillips). But i finally tracked down a supplier of Durable Medical Equipment(DME) that worked with my insurance. after more time waiting i finally got in touch with someone that knew what they were doing there!
Sterling Medical is who my meter came from, which they order from Alere.
The nice thing is that this is my meter and that i am not leasing it from Alere.
I still dont know what it cost me or my insurance for the meter. i recieved it in early Nov.
But if you do want to talk to someone knowalgeable in meters then call this guy:
Paul at Sterling Medical
1-800-216-5500
ext 68145
he seemed very qualified compared to everyone else that had no clue what an inr was.
Good luck and ask us anything... we all will try to help!
Thanks for all your input. I will be starting to investigate monday, starting with my insurance and the nurses at my cardiologists office. I got my bill from the coumadin clinic i currently im using. Over $200.00 per weekly visit. Outragest. I met my deductible for 2011 because of my surgery in jan, but will have to meet it every year for the rest of my life. It only makes since to me to purchase one for the long hall. I have uhc, and when you call them for a basic claim i want to pull my hair out, so wish me luck.
Klamdup
Klamdup
Klamdup:
UHC paid for my first monitor. But that was in late 2003, and I'm sure things have changed. Coverage depends on agreements between the employer and UHC.
Get something from your HR department on details of your coverage and see what it says about DME coverage.
Press for outright purchase, rather than rental.
UHC paid for my first monitor. But that was in late 2003, and I'm sure things have changed. Coverage depends on agreements between the employer and UHC.
Get something from your HR department on details of your coverage and see what it says about DME coverage.
Press for outright purchase, rather than rental.
