Finally threw in the towel.....

[dick0236]

......and am going back to my docs office for INR testing:eek2:. The final straw was today I received a bill from Tapestry Medical/QAS(on Alere letterhead) that I owed $47.38 and that I was 151-180 days late for $23.43 and 91-120 days late for $23.95. Actually, I have been begging Alere for several months to send me a bill:mad2:. They did send me a hand written bill on a "post-it note" that I refused to pay:confused2:. I have been on a bi-weekly testing program since July, 2009 and this is only the second time I have received a billing. I also had to beg for the first bill. If you have insurance that requires you to pay co-insurance, I advise you to examine your billings from your INR progam provider.

It is a shame that I had to stop this as it is very convenient and probalbly more accurate than going in for testing at my docs office. Oh well, I went into a lab or docs office for the first 42 years.....so it won't be difficult to make the transition back to the "old" way:redface2::tongue2:.

 

[njean]

So sorry to hear that Dick! I wouldn't want to go back to lab testing after having done that for 30 years!!

I thought you had medicare?

I have been on medicare for 1 year now & have BCBS as a secondary ins. & I haven't had to pay a penny for either the strips or the service. Before medicare came in, I would be charged for the strips on my credit card but then I would send the bill to BC & they would reimburse me for the cost of the strips.

You've got me wondering now.....

 

[Protimenow]

Dick:

I'm sorry to hear about problems you're having with Alere.

I don't know how Medicare provides for home testing, but I've got to believe that it's less expensive for them to provide you with a meter and supplies than it is for them to have to pay a lab or M.D.

What about getting a meter that you actually own, and buying the strips with a prescription? I've seen here that many of the forum members have their own meters, and a modest co-pay (if any) for the meters and testing supplies. Perhaps a chat with someone at Medicare or your insurance claim processor can shed some light on the situation. Perhaps someone else on the forum who has worked through this mess can advise you on how you can do the testing without having to go through a service to get your supplies and report your INR to your doctor.

(Personally, not having any insurance, and not being old enough for Medicare, I own my own meter and buy my own supplies. The meter(s) have been pretty inexpensive, and the supplies were bought under a prescription from a doctor and weren't TOO badly priced, but I'm not facing bills for testing that may or may not have been sent (as you note in your posting). Your doctor may be able to order your strips for you (strips are usually less expensive if bought directly by the medical professional) - and the doctor certainly should have no problem writing a prescription for the strips - if you have to buy them yourself. )

There should be some reasonable alternatives to the ones you've used - and I'll bet others here can give you some ideas. It just doesn't seem to make much sense that your provider would want to pay more for testing just so you can't have your own machine and do your own testing.

 

[Bina]

Dick, don't throw in the towel....fight back. Good Luck.

 

[njean]

Excellent advice from Protimenow & Bina! Fight back indeed, Dick!

Call Medicare & see what can be done so that you don't have to go back to lab testing.

I do know that Medicare requires you to test once a week & then you call in your results to Alere & then they call your doctor if the INR is outside the required perimeters.

Give it a try....what have you got to lose besides the freedom of home testing!!!!

 

[dick0236]

......You've got me wondering now.....

Norma, I am on a Medicare ADVANTAGE plan by choice. Some refer to these plans as medicare replacement plans. The premium is zero, -0-, but it normally requires more copayments than "Traditional Medicare" plus a "Medicare Supplement". I pay 20% of the Medicare allowed cost and medicare pays 80% on some services, such as INR home testing. My problem wasn't with what I owed...it was getting Alere to bill me in a timely way. I wonder if they would have reported me as a "slow pay" to the credit reporting agencies......that would have really pi--ed me off.

PS: Norma, medicare does not require once per week testing. They only require testing NOT more frequent than once per weed. From a pure cost standpoint, it will be less expensive for me to return to my docs office, where I will have Zero copay for either the office visit or test....and they use the same Coaguchek XS machine I had.....and my docs office is only about two miles away.....and the nurses are "cute".

 

[Duffey]

Norma, I am on a Medicare ADVANTAGE plan by choice. Some refer to these plans as medicare replacement plans. The premium is zero, -0-, but it normally requires more copayments than "Traditional Medicare" plus a "Medicare Supplement". I pay 20% of the Medicare allowed cost and medicare pays 80% on some services, such as INR home testing. My problem wasn't with what I owed...it was getting Alere to bill me in a timely way. I wonder if they would have reported me as a "slow pay" to the credit reporting agencies......that would have really pi--ed me off.

Well raise holy hell with Alere. I'm sure they can be reported to a BB agency, and I would sure as heck use that as a prod to get an answer to why they can't get a bill generated.

 

[ShezaGirlie]

Don't throw the towel in yet Dick.. You and I are both on a Medicare Advantage scheme and our programs pay different amounts for the INR service through Alere. I've never been charged by Alere and my cardio has only charged $36 total since I got on the scheme back in 2008. Reason I'm going on traditional Medicare is that my insurance company DROPPED the best hospitals in my area....creeps.:angel:

Since I'm going on traditional Medicare during the upcoming open enrollment period the other day I called Alere to find out what the charges would be:

1. Traditional Medicare w/no supplement costs to me = $8 per test which I think is looney tunes since I can buy the strips outright for around $8 each.
2. Traditional Medicare w/supplement - I'm looking at high deductible F* (new plan) which I wouldn't meet the $2K deductible for strips, but with annual premium of only $379 and 100% costs covered after the deductible for healthcare costs, it's a good deal. Have I mentioned yet how much I hate Insurance Companies..!!!
3. Buying CoaguChek XS outright and buying strips outright like I did from 1999-2008.

I did call Alere the other day, but threw my notes away..:thumbd:, so I'm calling them tomorrow to confirm the above and hope I get the same guy who explained the scheme to me. I do remember that he told me Alere is paid right at $20 by Medicare for an INR test. Yep, I asked..! Down here in Texas we'd refer to that as a 'whorehouse price'..:mad2: I suppose one could find that on the Medicare website since it's supposed to be public money.

The guy at Alere suggested I call the insurance guru at my cardio's office and get her thoughts on cost and best insurance company out there. I'll sure do that.

And Mizz Norma...you must figure in the premium cost of your Medicare Supplement to get an accurate cost of strips. Also, Medicare doesn't dictate that recipients test weekly - frequency is at the discretion of your cardio or whomever manages your Coumadin/warfarin. As Cooker says, "peace, out"..:wink2:

 

[Gail in Ca]

The nurse who trained me to use my new coaguchek xs said they are about ready to drop Alere and deal with Roche directly.
I am just starting to use my supplies from my start kit. The machine is mine, although Alere sent me the wrong paperwork initially that said I was only borrowing the machine and that they owned it. I called and got that straightened out immediately! I can see that going to my cardio or pcp's office to test would be okay if I didn't have my own supplies. They use the same machine, so no lab needles on scarred veins.

 

[lance]

Dick,
What a rigamarole! I hope things work out soon. Luckily your docs office isn't too far away.

 

[AgilityDog]

This crap is why I bought my own machine and buy my own strips. With my $3000 deductible, Phillips was charging me $258 PER MONTH!!!!

Can you say BULLSH!T??

 

[dick0236]

Can you say BULLSH!T??

Laurie........such language:eek2::wink2:. But you are "rite on". Maybe there will come a time that I will return to home testing.....but for now, my docs office is the lesser of two evils:rolleyes2:.

 

[Kathy McCain]

Sorry Dick you are having problems. Sounds like it's going to be okay though. Take care

 

[Protimenow]

Laurie:

Your language has lost its sting - just like a lot of language that is common vernacular for people from their teens on up. I realize that Dick was probably kidding when he commented on that famous two syllable word. (Rhetorical question: why is saying B.S. okay, but expanding the abbreviation isn't?)

$258 a month for testing? I own my machine and I buy my strips -- and I'm sure that others on the forum do, too - and many have been reimbursed for the cost of meter and/or strips. Compared to $258 a month, it sure sounds that owning your own machine is a good choice.

I bought my machines on eBay, but I've seen a few posts where people have said that when they told the licensed dealers of the meters that they're paying out of pocket, the prices can come way down. (Of course, if they count the $258 a month that you're paying against the deductible, you'll probably hit that deductible much faster than if you owned the meter and paid for supplies out of pocket).

And Dick, if going to your doctor's office for a fingerstick (and not a venous blood draw), costs nothing out of pocket, and isn't too big a hassle for you, I'm behind you all the way (I don't presume that my opinion means a hill of beans, anyway). (I still think you'll eventually get Medicare to provide you with meter and strips so you don't have to travel to your doctor for testing).

 

[ALCapshaw2]

The Downside of the Medicare Approval for Home Testing is that they still want you to submit your reading to a DOCTOR (or someone he designates to oversee anticoagulation management) and for That Person to advise what to do with your dosing. Some of our members have convinced their Doctors that they can dose themselves just fine and their Doctors sign off on that.

Some of us aren't so lucky and have Doctors (or clinics) who do NOT want to support Home Testers (i.e. there's not enough in it for THEM). A local For-Profit Hospital has a (one nurse) Coumadin Clinic that does support Home Testing BUT still requires a clinic visit every 6 weeks to "check your meter against theirs" (INRatio). I'll stick with my local clinic which provides EXCELLENT management care with their well-trained CRNP's and is covered 100% by my insurance. Besides, I like the Nurses (but NOT the drive!)

 

[njean]

And Mizz Norma...you must figure in the premium cost of your Medicare Supplement to get an accurate cost of strips. Also, Medicare doesn't dictate that recipients test weekly - frequency is at the discretion of your cardio or whomever manages your Coumadin/warfarin. As Cooker says, "peace, out"..:wink2:

Fortunately for me, I have never had to pay anything for the strips because I have Medicare & Blue Cross Supplement. And, I do remember that a representative either at Alere or Medicare, telling me that I had to do weekly testing and call in my results to Alere in order for Medicare to pay??? Wrong information.....not sure?

What I find weird is that my new cardio said he prefered that my PCP monitor my INR results because I had been with the PCP longer. So the INR results are being diverted to the PCP's office. Who can figure????

 

[dick0236]

Fortunately for me, I have never had to pay anything for the strips because I have Medicare & Blue Cross Supplement. And, I do remember that a representative either at Alere or Medicare, telling me that I had to do weekly testing and call in my results to Alere in order for Medicare to pay??? Wrong information.....not sure?

Njean, before I signed on to self-test about 1.5 years ago, I asked both Phillips and QAS about testing frequency. Phillips policy was that it MUST be weekly. QAS said it was up to my doc. They even had a "box" on the Rx form where the doc checked either "weekly" or "blank times per month". Mine checked "twice per month" per my request, since for me, weekly testing is "overkill". I normally have done it bi-weekly since enrolling with QAS/Alere except for a few times my INR got out of range.