Roche sucks

[TheGymGuy]

Folks you are about to see me vent. A warning has been issued.


Ok, so after calling Roche, UHC, Roche and UHC again, I finally got the Roche to get the approval and get a "care coordination reference number" for my PT/INR device (coagucheck xs).
Here is the kicker for past 5 weeks there was nothing done, nothing! Even though my cardiologist sent all the forms in 2 days after my OHS and I responded with my forms to their request about 10 days post OHS. So, last week I decided to call Roche and see what's up and basically after the tango above with UHC and them, I get a call back saying that they got all the paperwork for UHC approved but it is their policy to not give a device to a person until they have been on Coumadin for 3 month. What gives?!?!? This same device is used by the clinic which I will have to go to weekly now and who will charge me $30 per visit. This rule is DUMB!

I am almost thinking of either buying this device myself on ebay or here: http://www.fhmedicalservices.com/Co...eter-Care-Kit-and-1-bx-CoaguChek-Lancets.html



Venting done. Urrrghghghhhhhh!

 

[Freddie]

It's been my understanding that waiting 3 months is/was standard practice.

 

[dwhist]

I was also told the 3 month rule and had to wait for mine. Which meant I had to go to hospital each week for blood draw as I was bouncing around alot on my INR. Still high but hoping to get it down.

 

[TheGymGuy]

I see references to it on the web in some places but not others. I wonder what the reason is. Some people seem to get it really fast, others have to wait for 3 month.

 

[Protimenow]

I've seen the thing about three months, too. I'm assuming that it's because the INRs may fluctuate a fair amount during that period, and the meter manufacturers don't want to be involved in any negative events that could result from inadequate monitoring. Or something.

I'm pretty sure that Roche isn't giving you (or your insurance) any kind of price break. You might be able to buy a meter from a medical supply company, or over the Internet (I got my ProTime and InRatio meters on eBay and COULD have had an XS for under $50 but declined because I didn't know if I could afford the strips -- dumb).

If you don't want to wait the three months, buying your own meter may be a good idea - short and long term. You might even shop for meters -- I may have had an issue with my InRatio, I couldn't verify the same issue with the CoaguChek XS because I don't have access to one -- but is SEEMS as if the ProTime - an older technology that may actually avoid issues I may be having with the InRatio and a newer meter (which I'm hoping to get my hands on for testing soon), may actually provide results that are closer to lab results.

My meters were purchased on eBay -- and seem to work just fine.

 

[Bina]

Folks you are about to see me vent. A warning has been issued.


Ok, so after calling Roche, UHC, Roche and UHC again, I finally got the Roche to get the approval and get a "care coordination reference number" for my PT/INR device (coagucheck xs).
Here is the kicker for past 5 weeks there was nothing done, nothing! Even though my cardiologist sent all the forms in 2 days after my OHS and I responded with my forms to their request about 10 days post OHS. So, last week I decided to call Roche and see what's up and basically after the tango above with UHC and them, I get a call back saying that they got all the paperwork for UHC approved but it is their policy to not give a device to a person until they have been on Coumadin for 3 month. What gives?!?!? This same device is used by the clinic which I will have to go to weekly now and who will charge me $30 per visit. This rule is DUMB!

I am almost thinking of either buying this device myself on ebay or here: http://www.fhmedicalservices.com/Co...eter-Care-Kit-and-1-bx-CoaguChek-Lancets.html



Venting done. Urrrghghghhhhhh!

Well, I think that you need to clarify whom it is that you are venting about. The American system to receive home monitors is
usually multi-level and costly and teeming with rules and regulations. Roche seems to be a hostage in that game.
Where I live, Roche has been completely efficient and professional, the best customer service I have had in a long while.
Maybe buying from your medical services website will be worthwhile. Good Luck.

 

[Scott]

I had to wait 6 months to get mine!!

 

[TheGymGuy]

Well, I think that you need to clarify whom it is that you are venting about. The American system to receive home monitors is
usually multi-level and costly and teeming with rules and regulations. Roche seems to be a hostage in that game.
Where I live, Roche has been completely efficient and professional, the best customer service I have had in a long while.
Maybe buying from your medical services website will be worthwhile. Good Luck.

You do have a point, I meant to say I vented about Roche. I should have made my title more descriptive

UHC was very helpful in telling me to tell them what number to call, which extension to use and what to ask for to get their request into the proper system. UHC did all that cause Roche could not get the order into the right system or something like that. I swear, I felt like they (Roche) have never done this before. After I did all of the footwork I hoped to get the device pretty soon. Them telling me that it takes 3 month was like a slap in the face (after I did everything). I wish I knew that earlier so that I could order my meter before OHS and be using now, saving me $30 each time I need a measurement.

You'd think I am really angry, well, I sort of was. Now, I am just in a waiting mode.

 

[Protimenow]

It certainly would have helped smooth out your expectations - or cause you to take another course of action - if Roche had told you about the waiting period when you first contacted them.

 

[TheGymGuy]

It certainly would have helped smooth out your expectations - or cause you to take another course of action - if Roche had told you about the waiting period when you first contacted them.

You are spot on, mate.

 

[newmitral]

I wish I knew that earlier so that I could order my meter before OHS and be using now, saving me $30 each time I need a measurement.

I posted about this in a different thread, but it is not just a random 3 month waiting period. The physician ordering the home testing has to certify that you have been on anticoagulation therapy for at least 3 months. I'm not sure whether this restriction is placed by the meter manufacturers or the insurance providers.

In fact, from the Alere website, relating to the Inratio2 meter, on the physician's prescription form:
"I certify that this patient has been on warfarin therapy for >90 days and will undergo a training program utilizing the Alere Face-2-Face® training protocols to ensure that he/she is capable of self-testing;"

You can't just order the meter 3 months before you think you may need it - at least not via the official insurance-paid channels. The only other way to get a meter sooner is to buy your own outside the insurance system.

I assume they want you to have at least a 3 month history of ACT management via supervised doctor/clinic testing to ensure your INR is stable before introducing the additional potential variable of the home test meter and unsupervised procedures.

 

[Jason]

Same here, but it wasn't Roche that forced the issue, it was the insurance company in my case. I believe the earlier poster who said it probably has to do with the fluctuating INR's early on and liability is spot on. I remember the three month waiting period being frustrating myself, but it will be over soon and you will have your own meter.

 

[TheGymGuy]

Agreed. I hope this discussion will help next folks inline for this procedure to decide for themselves early on and be able to even double check the lab work from the comfort of their home.

 

[Superman]

I had to wait a couple years to get mine since my insurance didn't coordinate with the providor that my lab uses. Now, even worse is that next year I'll be switching insurance and it will cost me more out of pocket to home test than it will cost to go into the lab for needle sticks.

Costs $10 a strip and they require weekly testing or I lose use of the unit. I'll have 50% DME (which the strips fall under). So $5 a week vs. 10% out of pocket for a $17 dollar needle stick that I'm only asked to go in for once per month.

Home testing is convenient, but it's more expensive for both my insurance and me. Unless I have a stroke because of infrequent lab testing. Then it'll get pretty expensive not to home test.

I did recently have generic providers switched on my 5mg warfarin. This caused a pretty solid uptick in my range (started testing at 4.0 INR instead of hovering around 3.0 as usual). Weekly testing caught this quickly. Monthly, would not have been as efficient or convenient. Reduced my 6mg doses from every other day to 2x weekly and I'm back in range as of today.

 

[Superman]

3 month wait also has to do with being certain you'll be a long term warfarin patient. You and I know mechanical valve = lifer. But insurance doesn't want to pay for a machine unless they are absolutely certain you'll be long term and it's pretty standard for a tissue valve recipient to only be on ACT for three months. I would guess that it's easier just to make a standard accross the board 3 month rule on warfarin patients than it is to track seperate rules based on all the different reasons one might be on warfarin.

 

[Protimenow]

Superman:

If you own your own meter, nobody should be able to tell you when you have to do testing, and you'll probably be able to buy your own strips. I'll bet you can do a lot better than $10 each -- and insurance SHOULD reimburse a good chunk of the cost.

If it only costs you $1.75 out of pocket for a monthly lab test, why not do both - and use the monthly lab test as a confirmation that your meter is accurate?

 

[Superman]

I'm comfortable with the meter results and I'm running kids everywhere and work full time. Getting to the lab is a big pain, so no point in doing that.

Leasing the meter through Real Time Diagnostics is the lowest out of pocket for me. Under current coverage - costs me nothing. Next year - it'll be about $20 a month out of pocket (roughly $5/strip). No cost for the meter.

If I bought one, it'd be between $500 - $1,000 out of pocket for the meter and a big insurance battle to get them to cover 1/2 to get the cost that low. Took me a good long time to get them to understand I wasn't a diabetic looking for test strips. Kept routing me to the wrong place and I have only so much time to put into chasing this around.