Remote INR taking over Coaguchek

[MdaPA]

Also asked them about the bills, why I had not received anything yet and that I NEED to get billed in 2020 so that things go on my healthcare for this year against which I reached my deductible already like 5 months ago.

If you receive the bills in 2021, they should have a date of service in 2020 and your insurance company will apply them towards your 2020 deductible accordingly.

 

[DachsieMom]

I couldn’t reach them through the phone system today but then was able to get in using my account number.
I waited on hold 45 min yesterday and was also told bills were sent last week. However, that’s what I was told the week prior as well.
Anyone use Acelis? Like them?

 

[pellicle]

So tell me again why you don't just buy a tester and test yourself?

 

[MdaPA]

So tell me again why you don't just buy a tester and test yourself?

Unlike some other countries, we in the U.S. can't buy the machine directly through the manufacture (Roche). We either need to go with a monitoring service or buy from a 3rd party like eBay.

If using a monitoring service, they will loan/rent you a machine, provide training, technical support, and send you supplies (strips, lancets). If there is ever a problem with the machine, they will troubleshoot it or they will send you a replacement. They also act as a "middle-man" where you report your results through them and they communicate it to your doctor. They also work through your insurance.

If you buy from a 3rd party, it's "buyer-beware" like any other purchase. i.e. you need to find a reputable seller, make sure you get a new machine/unopened box (if you don't want a used one), you probably will not get a warranty, tech support or training, and you need to find your own supplies. Unless you are comfortable managing your own results and dosage, you will need to find a doctor who will work with you directly (some on this site have mentioned their doctor won't). And you will need to check with your insurance company to see if they will cover this (some won't without the service).

You get what you pay for. If using a monitoring service, you are paying extra for their service and benefits. If going through a 3rd party, you can save some money but won't get all the benefits and comforts if going through a monitoring service.

If it was me testing, I would go through a 3rd party to possibly save some money for the machine and supplies, but as my wife is the one testing, she prefers the piece of mind and convience of going through a monitoring service.

 

[ScribeWithALancet]

Unlike some other countries, we in the U.S. can't buy the machine directly through the manufacture (Roche). We either need to go with a monitoring service or buy from a 3rd party like eBay.

If using a monitoring service, they will loan/rent you a machine, provide training, technical support, and send you supplies (strips, lancets). If there is ever a problem with the machine, they will troubleshoot it or they will send you a replacement. They also act as a "middle-man" where you report your results through them and they communicate it to your doctor. They also work through your insurance.

If you buy from a 3rd party, it's "buyer-beware" like any other purchase. i.e. you need to find a reputable seller, make sure you get a new machine/unopened box (if you don't want a used one), you probably will not get a warranty, tech support or training, and you need to find your own supplies. Unless you are comfortable managing your own results and dosage, you will need to find a doctor who will work with you directly (some on this site have mentioned their doctor won't). And you will need to check with your insurance company to see if they will cover this (some won't without the service).

You get what you pay for. If using a monitoring service, you are paying extra for their service and benefits. If going through a 3rd party, you can save some money but won't get all the benefits and comforts if going through a monitoring service.

If it was me testing, I would go through a 3rd party to possibly save some money for the machine and supplies, but as my wife is the one testing, she prefers the piece of mind and convience of going through a monitoring service.

Alternatively, you could purchase a Coag-Sense as Protime did. I purchased one with a prescription after reading Protime's experiences. My internist had originally balked wanting me to purchase one through the insurance plan. However, when I told him about the financing shenanigans going on he agreed that a straight forward purchase where I knew what the money costs were would be better then dealing with unknowns. I have had it for about 1 and one half years and it has worked perfectly. I got it from Wilburn Medical as Coag-Sense does not sell direct.
https://wilburnmedicalusa.comThere are other medical suppliers that sell it as well. Wilburn staff told me that most of their Coag-Sense customers are dissatisfied customers from other machines usually due to service quality issues. I was told that the Coag-Sense was a bit harder to use then the CoagUChek but after watching the videos, I was able to master it after a few tests.

I found a study online that demonstrated that the two devices correlate similarly when you run a correlation between it and the Laboratory device test (provided that you use the same lab and the lab consistenly use the same machine and thromboplastin each time). If you search on this site you should be able to find the same on line conversations. My insurance company had a contractor with a CoagUChek for sale but the contractor wanted too much for it. It was not covered by their service contract but they were willing to warranty it themselves. Many on this site have purchased the CoagUChek on eBay and other places as well. I liked buying the Coag-Sense with a one year warranty.

The warranty paid off as I unknowingly abused it by pulling out the strip before the INR Test Meter was ready. They sent me a new machine at no cost and warned me about what I was doing. Apparently a lot of their customers were doing the same thing - not waiting for the home screen to show up before removing the strip.

The machine correlates perfectly to my labs machine. The regression equation is easy to compute as it only has two variables - the INR test machine and the lab machine.

Wilburn Medical has occasional sales on INR Test Meters and you can check with them on that. The test strips are made in California and the machine is made in South Korea so everything seems to work well.

Walk in His Peace,
Scribe with A Lancet

 

[pellicle]

Unlike some other countries, we in the U.S. can't buy the machine directly through the manufacture (Roche).

normally one does not need to buy direct of the manufacturers, mostly one buys from a retailer. I know they are for sale in the USA. I've had mine 8 years and its travelled around the world with me. On a per test basis its worked out under $1 per test for the cost of the machine (and its still going), strips are on average $6 each. All this is less than most "co pays" ... but then I shouldn't need to clarify that because its pretty much self evident.

The warranty paid off as I unknowingly abused it by pulling out the strip before the INR Test Meter was ready.

I am confused why this is a warranty because I've pulled strips from the meter before it was ready. Indeed doing this causes no harm. I know someone who routinely does it.

 

[ScribeWithALancet]

... ...



I am confused why this is a warranty because I've pulled strips from the meter before it was ready. Indeed doing this causes no harm. I know someone who routinely does it.

The CoagSense has a spinning wheel in it. One lets the INR Test Meter "spin up" at the beginning of the test and injects the blood onto the spinning wheel. The meter then uses a laser to observe when the blood actually coagulates. This is the direct measurement of the formation of a clot by the laser rather then the indirect measurement though electrical transmissions through a biochemically modified blood sample. According to a research professor that I talked to, this method (of actually detecting the formation of a real world clot), is theoretically more accurate (then measuring a change in electrical flows) but in his statistically measured world, they are statistically identical.
-
However, the spinning wheel, on the test strip, is physically interfacing with a spin driver in the INR test insturment. This spin driver, on the test instrument, must disconnect, from the spinning wheel mechanism on the test strip, before the patient pulls the test strip out. Otherwise, the two mechanisms are still physically engaged and something can be damaged. This is a physical interface not simply an electrical interface.

A press of an electronic button and a brief pause is all it takes. To the best of my knowledge, the CoagSense is the only INR test instrument that measures the physical formation of a real world clot via laser measurement. Thus, if your friend is using a different instrument, he would never face this physical interface issue.

Walk in His Peace,
Scribe With A Stylus

 

[Sheenas7]

I wrote to Bio tel today after checking with my doctor’s office and finding out that they had not received my test results. Here is their answer and based on that I will hope they fixed the problem.

 

[Sheenas7]

I wrote to them after finding out they had not reported my test results to my doctor last Tuesday. They answered and I hope it’s true that they did fix the problem. I will attach the email I received from Bio Tel

 

[MdaPA]

I've had mine 8 years and its travelled around the world with me. On a per test basis its worked out under $1 per test for the cost of the machine (and its still going), strips are on average $6 each. All this is less than most "co pays" ...

You can't beat $1 per test! FWIW....my wife's co-insurance for Coaguchek service is $10.43/month (includes meter rental, strips, lancets, and reporting service) and $1.52/week for her doctor to manage her INR. So the cost per weekly test comes to about $4. If she goes to the lab, her co-insurance is $0.42.

I got it from Wilburn Medical as Coag-Sense does not sell direct.

Thanks. I will bookmark Wilburn Medical should my wife drop Coaguchek/BioTel service and needs to purchase a machine.

 

[MdaPA]

I wrote to Bio tel today after checking with my doctor’s office and finding out that they had not received my test results.

If my wife can't get through to BioTel Heart after a few minutes on hold, she hangs up and reports her results directly to her doctor's office. Regardless, nothing to worry about if your INR is in range and no dosage change would be needed anyway.

 

[pellicle]

my wife's co-insurance for Coaguchek service is $10.43/month (includes meter rental, strips, lancets, and reporting service) and $1.52/week for her doctor to manage her INR. So the cost per weekly test comes to about $4. If she goes to the lab, her co-insurance is $0.42.

that's pretty cheap ... can't argue with that.

The only thing I've got up my sleeve is based on the facts that

• to get to a lab conflicted with getting to work on time
• the reporting from the labs usually took a few days, so it introduced a lag
• I move around a bit and spend some time OS, so taking my coagucheck with me is essential

for your situation I wouldn't shift, however I do read many complaints from people here where its far more expensive / inconvenient than that.

Best Wishes

 

[pellicle]

The CoagSense has a spinning wheel in it.

I'm sorry ... I missed you had one of those things.

so that's "yet another thing" I don't like about that system.

To the best of my knowledge, the CoagSense is the only INR test instrument that measures the physical formation of a real world clot via laser measurement

well it depends on if you consider microcsopic movement movement (I sure do) and electrochemical is quite common ... back when I did my degree in microbiology and biochemistry stuff like electrophoresis was like "the word" ... still is. The spinning wheel thing sound quaint, and a bit steampunk to me.

FWIW this is how the i-Stat system (used in many labs) works:

 

[pcannon]

I couldn’t reach them through the phone system today but then was able to get in using my account number.
I waited on hold 45 min yesterday and was also told bills were sent last week. However, that’s what I was told the week prior as well.
Anyone use Acelis? Like them?

I use Acelis DachsieMom. I wouldn't say I like or dislike them. I've only been doing this since June 2020. I did have a problem getting strips in a timely manner but that could have been because of shipping problems. Recently my insurance got a bill for Sept, Oct, and Nov but I only got strips in Sept and Nov. I've hit my insurance limit for the year already and shouldn't have to pay anything but they sent me a $14.71 bill for October also. Usually I only pay $10 for my strips and lancers. I sent an email inquiring about the Oct bill. I usually get 12 strips and 16 lancers, test once a week sometimes twice since my INR is all over the place. I don't know if this helps or not but this has been my limited experience with Acelis.

Peggy

 

[BluesCards]

I just wanted to add my two cents to this. I had my surgery July 2019, mechanical. By finding this forum before my surgery, I asked my Doctor to let me test weekly. He agreed, so weekly pokes it was, with a half hour drive to the lab, wait, then half hour home.
I also asked about home testing and was set up for that, however, it could not start until 3 months after surgery. I said I wanted to just buy my own machine and self test. I found the Wilburn Medical site and saw all I needed was a doctor authorization. They provided the needed form as well. I ordered my machine and filled out the form. Sent to my doctors office, he signed off and I got my machine in September 2019. Started self testing that week. I did two more lab draws followed by self test at home and felt comfortable with the numbers.
I got the Coagsense that requires the little transfer tube. The package I got included the meter, a years supply of tubes, testing strips and two years worth of lancets. The price was well worth it to go this route vs some third party monitoring. The price I got from them was crazy.
Once I started home testing, it took a few tries but I am really good at it now. I have already re-ordered strips from Wilburn Medical once and that does not require a doctor sign off. I have been testing weekly and email my cardio via the patient portal and his staff reads and then adds to my chart. No charge for any of that. I am very happy he let me go this route, and glad I pressed it with his office. I did find out quite a few people that see him and others in the cardio department do self testing. I also want to point out that I have done a lab to home check comparison about every 6 months and so far so good, as the values are very close.

Anyway, just wanted to share my experience with this, and give thanks to this forum as it has helped me quite a bit.

 

[SLV]

Unlike some other countries, we in the U.S. can't buy the machine directly through the manufacture (Roche). We either need to go with a monitoring service or buy from a 3rd party like eBay.

If using a monitoring service, they will loan/rent you a machine, provide training, technical support, and send you supplies (strips, lancets). If there is ever a problem with the machine, they will troubleshoot it or they will send you a replacement. They also act as a "middle-man" where you report your results through them and they communicate it to your doctor. They also work through your insurance.

If you buy from a 3rd party, it's "buyer-beware" like any other purchase. i.e. you need to find a reputable seller, make sure you get a new machine/unopened box (if you don't want a used one), you probably will not get a warranty, tech support or training, and you need to find your own supplies. Unless you are comfortable managing your own results and dosage, you will need to find a doctor who will work with you directly (some on this site have mentioned their doctor won't). And you will need to check with your insurance company to see if they will cover this (some won't without the service).

You get what you pay for. If using a monitoring service, you are paying extra for their service and benefits. If going through a 3rd party, you can save some money but won't get all the benefits and comforts if going through a monitoring service.

If it was me testing, I would go through a 3rd party to possibly save some money for the machine and supplies, but as my wife is the one testing, she prefers the piece of mind and convience of going through a monitoring service.

Thank you. May I ask how the results from the doctors office or anticoagulation clinic (acc) receiving those results are billed and paid? That seems to be the issue I am having trouble with on the Non Medicare side. I can work with a monitoring service- but I can’t find a resource on the Drs side or acc side to take the results as the insurance does pay.,Seems to me if that is a requirement they should have and inside staff as part of their service. I have found certain acc clinics will bill as an office visit and it is then a nominal fee - much cheaper than the monthly monitoring service. It should not be this hard! Thank you all

 

[DachsieMom]

Still no bill from Remote INR. Ugh. Did anyone get one? I can’t bear to call them back again and wait on hold for an hour.

 

[MdaPA]

Still no bill from Remote INR. Ugh. Did anyone get one? I can’t bear to call them back again and wait on hold for an hour.

Nope, did not receive a bill since June 2020. Not worried about it or calling them looking for it either.

If you receive the bills in 2021, they should have a date of service in 2020 and your insurance company will apply them towards your 2020 deductible accordingly.

 

[Sheenas7]

I haven’t received any bills . Just explanation of benefits from my insurance. I have Medicare and Cigna. Waiting to see what happens. I just hope they do send supplies on time when we need them. I was able to report my results by phone last Tuesday so it looks like they made progress on that.

 

[RAS]

I received my first bill from Remote INR/BioTel this week which was for my second shipment this year which apparently occurred after BioTel acquired the service. I've never talked to them about it, but had previously discussed billing with Roche because they had billed me for my first shipment this year as if their service was not covered by my insurance (which was incorrect). I never received a corrected bill from Roche. The bill from BioTel was correct matching the insurance contracted amount.

As far as reporting results, nothing there has been a problem, but I use online reporting rather than phone call. The website looks the same as always except for the Remote INR BioTel logo that was added after the acquisition.