I am a too frequent tester ...

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realkarl

realkarl

Radiation survivor
Supporting Member
Joined
Jun 3, 2009
Messages
187
Location
Seattle, WA, US
.. according to my anti-coagulation clinic. Yesterday a nurse from the clinic called to complain I was testing once per week, and wanted to know why I was doing so.... Since I always was in range, she told me I really shouldn't be testing more than once / 4 weeks, and she needed to document why I was testing too frequently.

I pointed to documentation explaining the increased safety with weekly testing, and that's why I was home testing in the first place. She wasn't convinced, and I didn't try elaborate, but stuck to the increased safety argument. And of course I couldn't bring up that I make minor adjustments, and that's why I stay in range, nor that I was 0.1 out of range once, but adjusted it down to 3.0 to avoid having to deal with them, and instead had a large serving of spinach the next day...

I should send them an e-mail offering to report only once / 4 weeks, or if go out of range and need help getting back in, so they don't have to deal with my paperwork.

My insurance covers up to once/week testing, and I think I need to report weekly to QAS to get a timely strip refill at 80% coverage. QAS faxes the result to my anti-coag clinic.

Karl.
 
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If you are "renting" the machine, where you have to call QAS with your results, then they may have a requirement that you test once per week for liability purposes. If you own the machine, then you can choose how often you can test. Personally I think once per 4 weeks is great, but that's for me and my comfort level only. You would have to clear this with QAS if they are reporting your results.
 
I own the machine and will continue to test weekly. If my insurance gives me trouble refilling strips, even though their regulations allow this, I will just have to buy my own strips (at about 25% of the "full" price QAS charges, just a little more than the 20% I pay through insurance/QAS)
 
My first 18 months of testing was in the lab setting and I was thrilled that I could test only every 4 weeks and be rock steady. In reality, I never would have known if my INR had taken a dip two weeks earlier and bounced back. I wanted more control of my own tests and meds.
Then my veins started to suffer, and I came here and discovered that Ross and his gang knew of what they spoke.
I Bought my own machine lickety-split, and have never looked back.
Since my INR is still quite stable, I test every 2 weeks, my insurance pays the strips, and I am SO much more relaxed. :)
 
I've had my machine for 3 years now & I have been testing weekly. The machine is mine ---- it is NOT a rental. The once a week testing was recommended by my cardiologist but I never had to call in my results to QAS or him until this past November when I was picked up from Medicare. Their requirement is that I test weekly which I had been doing anyway, and call in my results to QAS.

Personally speaking, I am very comfortable with testing weekly because I feel I have better control of my INR range. And bottom line, it's my life on the line, NOT theirs!! :)
 
Forgot to add: The trick with weekly testing is not to "over react" if results are a bit high. Let it be for another week and check again.
Falling into the trap of "chasing" INRs is of no use at all.
 
Yeah, since I been home testing I've had some nurse's say the same thing. My new cardiologist sure didn't have anything negative to say about it when I told him I tested once a week.

I've also had some doctors and nurses say my control was too high. But it's my life and it's worked for me. I'll hold the 2.5 to 3.5 where it's been for the last 18 years.

I could have also chosen 2 week testing or monthly testing and I don't own my meter. Medicare pays on the amount of times I call QAS.
QAS reports my INR to the cardiologist office weekly.
 
realkarl said:
I pointed to documentation explaining the increased safety with weekly testing, and that's why I was home testing in the first place. She wasn't convinced, and I didn't try elaborate, but stuck to the increased safety argument. And of course I couldn't bring up that I make minor adjustments, and that's why I stay in range, nor that I was 0.1 out of range once, but adjusted it down to 3.0 to avoid having to deal with them, and instead had a large serving of spinach the next day...

I should send them an e-mail offering to report only once / 4 weeks, or if go out of range and need help getting back in, so they don't have to deal with my paperwork.

My insurance covers up to once/week testing, and I think I need to report weekly to QAS to get a timely strip refill at 80% coverage. QAS faxes the result to my anti-coag clinic.

Karl.
Click to expand...

My guess is the nurse doesn't want to be bothered with what she considers excessive paperwork & work. However, it sounds as though you've demonstrated the ability to pretty much keep your INR stable by making minor adjustments. BTW, being 0.1 out of range is nothing; a repeat test might have been in range.
What is the charge for your doctor's office getting these faxes and recommending changes based on INRs?

If there's a way to impress upon your doctor's office that you are able to keep your INR stable because of the weekly testing, maybe they'll see it your way.
After all, it is your money that's buying the strips.
 
catwoman said:
What is the charge for your doctor's office getting these faxes and recommending changes based on INRs?
Click to expand...
I don't know.

If there's a way to impress upon your doctor's office that you are able to keep your INR stable because of the weekly testing, maybe they'll see it your way.
After all, it is your money that's buying the strips.
Click to expand...
They have very rigid rules, and I am not about to embark on a quest to obtain special privileges. It was enough trouble getting the machine!! So I will continue as I have for now, as she didn't actually order me to stop testing weekly. If they give me trouble refilling strips at a weekly rate when I run out, I will make an appropriate change then :)
 
njean said:
I never had to call in my results to QAS or him until this past November when I was picked up from Medicare. Their requirement is that I test weekly which I had been doing anyway, and call in my results to QAS.
Click to expand...

Normajean, who told you that Medicare required weekly testing?
I filled out the QAS prescription form that I gave my doctor and I put down weekly testing. I could have chosen one test per week or every 14, 21, 28 days.
I was later told by QAS that I must call them after each test, that Medicare only paid on each test reported.
 
olefin said:
Normajean, who told you that Medicare required weekly testing?
I filled out the QAS prescription form that I gave my doctor and I put down weekly testing. I could have chosen one test per week or every 14, 21, 28 days.
I was later told by QAS that I must call them after each test, that Medicare only paid on each test reported.
Click to expand...

I talked to a QAS rep & he was the one that told me that Medicare required that the patient test weekly & call in the results to QAS in order to get paid for the strips. I told him that I had been testing weekly anyway so this did not present a problem to me.
 
I have been home testing since last July. My PCP prescribed every two weeks at my suggestion and QAS and my Medicare Advantage plan apparently do not have a problem with this schedule. I do "rent" the machine thru a program with QAS.
 
Medicare will only pay for no more then once a week testing. There is no mandate that you must test weekly.

For me, 2 weeks would be about as long as I could go without it starting to wander out of range without some attention being paid to it, so weekly testing works for me.
 
I do not want to hijack this thread, but I do have a question for those getting this "home test" service who are on medicare. QAS has billed my Anthem Medicare Advantage $280 for my last four completed tests . Anthem approved $113.79 and payed 80%, $91.03. My 20% share is $22.76 that has not been billed to me by QAS yet. Is this close to what Medicare approves/pays for your service.

I am on a QAS program where QAS provides my machine, strips, lancets etc. and I am recquired to call my results in to QAS.
 
realkarl said:
I own the machine and will continue to test weekly. If my insurance gives me trouble refilling strips, even though their regulations allow this, I will just have to buy my own strips (at about 25% of the "full" price QAS charges, just a little more than the 20% I pay through insurance/QAS)
Click to expand...

Karl:
One bit of ammo to keep in your hip pocket: Ask the nurse what she would do if she had a mechanical valve? Would she feel secure in testing only once a month? That's probably adequate for someone with a-fib or history of only one DVT episode. A-fib can sometimes cease; some people with DVT history are taken off warfarin. But some of us here will be on it forever. With an On-X, who knows? (But that's another story, another thread.)

Also, it's easier to remember to test weekly rather than once a month. 4 weeks becomes 5 weeks becomes 6 weeks, etc. At least, that has been my experience when I was trying to stretch my strips until my FSA account kicked back in for the new year.
 
dick0236 said:
QAS has billed my Anthem Medicare Advantage $280 for my last four completed tests . Anthem approved $113.79 and payed 80%, $91.03. My 20% share is $22.76 that has not been billed to me by QAS yet. Is this close to what Medicare approves/pays for your service.

I am on a QAS program where QAS provides my machine, strips, lancets etc. and I am recquired to call my results in to QAS.
Click to expand...

Dick, I'm on Medicare, use QAS but I have AR Blue Cross Medi-Pak.
Each month for 4 test QAS billed $280, Medicare allowed $118.82, of which they pay 80%, $95.06. Med-Pak paid the 20%, $23.76.
 
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