Raytel/QAS and Independence Blue Cross

[Taylor]

Hi all. I have been testing at a coumadin clinic which has been fine other than the fact that it is only open on weekdays from 9 to 5 which is a bit inconvenient from a work perspective. I contacted Raytel about home testing because my cardiologist had information on them when I went to my post-surgery follow up with him a week after my valve replacement. The Raytel folks just called back to tell me they saw a note on the file that Independence Blue Cross doesn't cover the home machine because they feel is is just a convenience.

My two questions:

1. Does anyone have experience with getting home testing approved from Independence Blue Cross (I'm in San Francisco but my company is Philadelphia based hence the independence Blue Cross)? If so, is there any trick to it or any other advice you can give me?

2. If Raytel seems to have given up, should I still try to get some help from QAS or another provider?

Thanks all,

Taylor

 

[Ross]

Taylor Blue Cross is as bad as the Government. Expect them to say no and appeal. A piece of good fighting material would be in the reference section under CMS. I'd copy that and ask Blue Cross why the Government considers it a necessary item for people with heart valves and they consider it a convenience item?

Don't give up. Eventually they'll cave.

 

[Computec]

Things Change

Things Change

Hi Taylor...

Congratulations on your continuing recovery.

I agree with Ross about dealing with the insurance companies. I want to add that what the provider shows in their files relative to your insurance company is based on PAST experience.

Yes, the government now considers home testers as necessary for mech valve people while only experimental for other patients. This is a relatively new development.

My own insurance (Aetna) had the same attitude as yours until April of this year. Worst case scenario is that you pay for it yourself and then come at then with a done deal. As we say at work, "It's better to ask forgiveness than permission."


Jerry

 

[Karlynn]

I think QAS is your better bet. As far as I know Raytel only handles home testing in a "subscription" kind of way. They rent you the machine, you test weekly and call in your # to them, they in turn contact your doctor. From what I hear, if you don't test and call on the day you're supposed to, they send out the hounds.

If this is the only way you can get a home testing unit - it's still better than going to a lab. But most of us prefer eliminating the middle man and just deal with our home testing with our doctors.

 

[fyrfytr]

I can't use QAS with my current ins. company so I had to find a new company. I contacted Raytel and they work with my ins. Raytel has two ways that you can use. You can purchase a unit from them and supplies or you can use their testing unit, they send you a new unit free of charge and you purchase your supplies from them. I test weekly anyway so this is the way I went. You call in your INR and they let your Dr. or Clinic know your INR and your Dr. or Clinic contacts you to adjust your dose or what ever needs to be done. It isn't that bad and THEY DO NOT HOUND YOU!!!!!!!!!!!!
My Clinic only calls me if my INR is above 4.5 or below 2.0. They let me adjust my dose as needed.

 

[maggiemay]

Raytel home testing

Raytel home testing

I have contacted Raytel and my Dr. has sent letter of medical ness. paper along with the precript. for the weekly testing.They said they would take care of everything after that, that was on June 22nd. I am still waiting, in fact I spoke to them today and gave important ins. info. amd they told me I could purchase it on my own for $900. but they would charge the ins. $1500. No one even mentioned that they could send me the tester if I bought my supplies from them. Could you please let me know who you talked to and what where the reasons they offered this to you. I am very,very frustrated with them because they seem to be dragging their feet. Almost as if they would rather I just pay for it myself. I am actually starting to get knotts in my arms from the weekly draws. Thanks

 

[Karlynn]

Sounds like Raytel has changed their tune. When I was looking to buy a new monitor, they told me they don't sell them, but rent them as part of their testing program. I had been purchasing my supplies from them for about a year. Are they telling you that you will have to call in your INR to them? I also got a letter from them saying that they were no longer going to deal with insurance companies because they weren't getting paid by them. There was a discussion on that a year or so ago. Maybe do a search on Raytel and go back a while.

Make sure they are very clear on what they are selling you and what their expectations are.

 

[Dennis S]

Raytel gives you a computerized call if you don't call in weekly. That seems proper to me, as people do tend to forget, and they are better off if they test weekly. I don't pay any particular attention to the calls, but would be a better patient if I I did.

Actually, I don't pay any attention to any of them, as I feel no one is better qualified than I am as far as determining the proper doseage to keep me in range. Best thing I ever did--picked a nice nurse practitioner without a big ego to receive the fax of my test results from Raytel. She agrees that I am competent to adjust my own doseage, and neither one of us bothers the other. I hear from her once in a while just to touch base, and I am sure she would call if I was out of range on a significant basis. I have had no problem having Blue Cross/Blue Shield pay for the test materials, and Raytel has them delivered to our mountain top, dirt road home by Fed Ex within 72 hours of my telephone request.

 

[Karlynn]

Glad to hear Raytel isn't the watchdog I was lead to believe it was. It's also good to know that there are people out there that understand that managing and dosing one's own Coumadin isn't a fast track to the big dirt nap.

 

[denverman1]

Raytel

Raytel

I have been using Raytel for my INR weekly blood checks for over a year now and have not had any major concerns. My insurance covers it (United Health) and I only pay a monthly $15.00 fee. I am renting the tester and get my supplies from Raytel - always sent via FEDEX with 2 day service. I call in the results to Raytel (computer answering service). If it is out of my doctor's suggested range (2.5-3.5) then I usually get a call from the doctor's nurse that same day. I have been having some problems with testing strips here in last few weeks - I think is heat related (it is getting over 90 here in Colorado) - I have taken to storing them in the fridge until the temp cools down a little. Therefore I would recommend Raytel - since I really haven't encountered any major problems with them...

 

[Blanche]

Raytel does sell monitors

Raytel does sell monitors

We have been dealing with Raytel for more than three years. We pay for our own supplies by choice. Supplies always reach us in 2 days by FedX. If you wish to buy a monitor from Raytel they will sell you one, for cash, check, or credit card. If you have insurance, after paying for the machine, you can send the bill to your insurance for payment. If you are paying yourself, the transaction is fast.

We ordered an INRatio Monitor on Wednesday and just received it via FedX this morning.

Blanche and Al