Kaiser is threatening to pull my INRatio

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Jackie

Jackie

Well-known member
Joined
May 13, 2006
Messages
890
Location
Newark, California
Aug 29 my INR results were 4.5 on my INRatio. The Anticoagulation Clinic left me a message to go into the lab on Thursday. I in turn left them a message that I was out of town for a week and would come Wed the 3rd.

I went in Wed and the results were 2.9 Lab and 3.4 INRatio. I didn't get the results until yesterday from the lab. When the Clinic called me I was told that the Pharmacist had talked to someone at QAS and they told her that they could pull my unit if I didn't follow clinic rules. This is the only time I have not followed they rule in 2 1/5 years, and I was out of town.

The Pharmacist does not like the fact that I have a Home Testing Unit, she always says that I isn't accurate. I have tried to get her to read the information on the Hemosense website and she wont' because she said it would be a waste of her time. I wanted her to read about correlation between finger stick and vein draw.

I am the only one at this clinic to have my own unit. And prob ally the only one that will question her instructions. After all it is my life were talking about.

Does this sound right, that they could pull my unit? This is my best friend and I would be very upset if it happened.
 
Who owns the machine? If it's you, they can't do a thing about it. You just have a jackass to deal with. Tell her to call Dr.Jack Ansell in Boston and discuss her feelings about home testing with a professional physician who is a leading advocate for home testing or better yet, get the moron to watch the Discovery movie we have posted up top. They don't give credits for nothing!

Jack E. Ansell, M.D. is Professor of Medicine at Boston University School of Medicine and Vice Chairman for Clinical Affairs, Department of Medicine, at Boston University Medical Center.

Dr. Ansell received his medical degree from the University of Virginia School of Medicine. He completed his internship and residency in Internal Medicine at Tufts-New England Medical Center in Boston, and a fellowship in Hematology and Hemostasis at Boston University/Boston City Hospitals and the Boston VA Hospital. He is board certified in Internal Medicine and the subspecialty of Hematology.

Dr. Ansell's research has focused on the disciplines of Hemostasis and Thrombosis, especially in the areas of Thrombotic Disorders and Antithrombotic Therapy. He has had a continued interest and involvement in the application of new modes of delivering and monitoring anticoagulants, and particularly in the management of oral anticoagulant therapy. He has published extensively and lectured widely on these topics. He is the founder of the Anticoagulation Forum, a network of anticoagulation clinics throughout North America, and is a member of a number of professional organizations including the American College of Physicians (Fellow), American Society of Hematology, International Society of Thrombosis and Hemostasis and its Scientific Subcommittee on Anticoagulation Monitoring, American Heart Association, and American Medical Association. He Chairs the expert panel on Monitoring Oral Anticoagulant Therapy for the American College of Chest Physicians Consensus Guidelines for Antithrombotic Therapy and is an associate editor of the Journal of Thrombosis and Thrombolysis. He also serves as an editorial consultant for numerous journals including the New England Journal of Medicine, Annals of Internal Medicine, Blood, and Thrombosis & Hemostasis.


Maybe she needs to be threatened that if the machine is taken away from you and poses an undo hardship based on her lack of knowledge and you stroke out, that your family is coming at her with a lawyer big time. You might want to email Al Lodwick about it. He may have some recommendations for you also.
 
Jackie said:
Aug 29 my INR results were 4.5 on my INRatio. The Anticoagulation Clinic left me a message to go into the lab on Thursday. I in turn left them a message that I was out of town for a week and would come Wed the 3rd.

I went in Wed and the results were 2.9 Lab and 3.4 INRatio. I didn't get the results until yesterday from the lab. When the Clinic called me I was told that the Pharmacist had talked to someone at QAS and they told her that they could pull my unit if I didn't follow clinic rules. This is the only time I have not followed they rule in 2 1/5 years, and I was out of town.

The Pharmacist does not like the fact that I have a Home Testing Unit, she always says that I isn't accurate. I have tried to get her to read the information on the Hemosense website and she wont' because she said it would be a waste of her time. I wanted her to read about correlation between finger stick and vein draw.

I am the only one at this clinic to have my own unit. And prob ally the only one that will question her instructions. After all it is my life were talking about.

Does this sound right, that they could pull my unit? This is my best friend and I would be very upset if it happened.
Click to expand...

Hi Jackie,

I agree with Ross on this one!

Do you own your machine? If so, it is yours.. no one can take it away!

You wrote "the Pharmacist had talked to someone at QAS and they told her that they could pull my unit if I didn't follow clinic rules."

Who is "They"? QAS, or the pharmacy? I seriously doubt it was QAS, if so, I would call them and inquire / report the response someone gave the pharmicist.

It sounds more like a scare tactic. Is the phamacist affiliated with the Coumadin Clinic? hmmmmmm... sounds "fishie" to me. possible collusion even, if so, and I would consider reporting this to authorities.

Sorry to hear you are having a hard time with this. Hopefully you can get it resolved quickly.

Good luck!

Rob
 
I did call QAS, can't find out she talked because no notation was made on my account that this conversation ever took place.

QAS can pull my unit if I don't comply with MEDICARE STANDARDS, which is calling in my results to QAS weekly. I am checking, but it looks like QAS owns the unit because it is covered through Medicare.

I am checking to see if Kaiser can pull scrip to supplies. I won my appeal with Kaiser, for my unit, because Medicare is an advocate for home testing. Since my Medicare is turned over to Kaiser I would think that would be all inclusive. We will see, I am not finished yet. Maybe I can get a Pharmacist fired.

Thank you for your help.
 
I believe that you own the unit, unless Medicare has some sort of rental agreement. My guess is that the pharmacist is lying in an attempt to make your life miserable. Kaiser is the closest thing that the US has to universal health care, and it is an absolute mess! Please take note all you people who think that would be great! When the government controls our lives, they use any means they can to intimidate.
 
The story has now changed. I called to submit a grievance, the women called me back after I had explained what I wanted. She had talked to the Pharmacist's supervisor and she said that what had been said was that I could be band from the Anticoagulation Clinic, no mention of the unit being pulled. I really can't figure out how in the world I got, she had talked to QAS and they told her that my unit would be pulled hummmmmmm, dosen't sound anythig alike to me.

Now this would be great, except I would not have anywhere for my results to be faxed. That would keep me from being able to use the monitor because I am on a limited income and half to depend on Kaiser and my Medicare to finance it. My husband is in a long term care facility because of a heart attach 4 years ago which left him with brain damage. Expenses are very high. The saga will have to continue on Monday.
 
Lisa in Katy said:
I believe that you own the unit, unless Medicare has some sort of rental agreement. My guess is that the pharmacist is lying in an attempt to make your life miserable. Kaiser is the closest thing that the US has to universal health care, and it is an absolute mess! Please take note all you people who think that would be great! When the government controls our lives, they use any means they can to intimidate.
Click to expand...

From what I've read here at this website, if you get an INR machine through Medicare, you do not own the machine & it goes back to the vendor/Medicare upon your death.

Can someone please verify/correct my assumption?
 
You are right, QAS does own the unit. Thats why they could pull it, as mentioned above, if I did not comply with Medicare Standards.
 
Jackie, I'm not sure what's available in California, but if there's a way that you can switch your Medicare to a managed Medicare plan and away from Kaiser, you would probably be better off. I know that Blue Shield of California has a plan. It's called a Medicare Advantage HMO Plan.

My company offers such plans, and they generally have more freedom than what you're dealing with, unless you live in a small town and Kaiser is your only option.
 
Jackie said:
You are right, QAS does own the unit. Thats why they could pull it, as mentioned above, if I did not comply with Medicare Standards.
Click to expand...

Jackie look on the bottom of your meter. Is there a label or plate that says "Property of QAS"?

My impression of Medicares payment was, the prescribing physician actually buys the machine for the patient and then is reimbursed for it. Maybe things have changed.

As far as having somewhere to call your numbers into, QAS has a service just for this purpose.

http://www.inrcare.com/ppm_benefits.asp
 
Lisa, I'm not sure I could change insurance because of my AVR. I have had Kaiser for 33years and barley used it until 2 1/2 years ago. It worked when my boys were growing up because they never had anything seriously wrong. My husband had a serious heart attach and I doubt I could get coverage somewhere else for him either

Ross, I use the PPM number to call in my results for Medicare purposes, but they need a contact to fax my results to, in this case the Anticoagulation Clinic. These are Medicare Standards.

When I talked with QAS they explained that with Medicare cases they provide the unit on a Lease basis and bill Medicare for the supplies and phone /fax services. In this case my Medicare is turned over to Kaiser for Senior Advantage. And yes, there is a sticker on the bottom of my unit saying Property of QAS. Monday I hope to find out more. Thanks for the help.
 
Jackie said:
Lisa, I'm not sure I could change insurance because of my AVR. I have had Kaiser for 33years and barley used it until 2 1/2 years ago. It worked when my boys were growing up because they never had anything seriously wrong. My husband had a serious heart attach and I doubt I could get coverage somewhere else for him either

Ross, I use the PPM number to call in my results for Medicare purposes, but they need a contact to fax my results to, in this case the Anticoagulation Clinic. These are Medicare Standards.

When I talked with QAS they explained that with Medicare cases they provide the unit on a Lease basis and bill Medicare for the supplies and phone /fax services. In this case my Medicare is turned over to Kaiser for Senior Advantage. And yes, there is a sticker on the bottom of my unit saying Property of QAS. Monday I hope to find out more. Thanks for the help.
Click to expand...

Ask your cardiologist to become the contact. Explain to him what the problem is with the clinic and see if he'd oblige you as the designated contact. Hopefully he's not an airhead like the clinic.
 
Ross said:
Who owns the machine? If it's you, they can't do a thing about it. You just have a jackass to deal with. Tell her to call Dr.Jack Ansell in Boston and discuss her feelings about home testing with a professional physician who is a leading advocate for home testing or better yet, get the moron to watch the Discovery movie we have posted up top. They don't give credits for nothing!

Jack E. Ansell, M.D. is Professor of Medicine at Boston University School of Medicine and Vice Chairman for Clinical Affairs, Department of Medicine, at Boston University Medical Center.

Dr. Ansell received his medical degree from the University of Virginia School of Medicine. He completed his internship and residency in Internal Medicine at Tufts-New England Medical Center in Boston, and a fellowship in Hematology and Hemostasis at Boston University/Boston City Hospitals and the Boston VA Hospital. He is board certified in Internal Medicine and the subspecialty of Hematology.

Dr. Ansell's research has focused on the disciplines of Hemostasis and Thrombosis, especially in the areas of Thrombotic Disorders and Antithrombotic Therapy. He has had a continued interest and involvement in the application of new modes of delivering and monitoring anticoagulants, and particularly in the management of oral anticoagulant therapy. He has published extensively and lectured widely on these topics. He is the founder of the Anticoagulation Forum, a network of anticoagulation clinics throughout North America, and is a member of a number of professional organizations including the American College of Physicians (Fellow), American Society of Hematology, International Society of Thrombosis and Hemostasis and its Scientific Subcommittee on Anticoagulation Monitoring, American Heart Association, and American Medical Association. He Chairs the expert panel on Monitoring Oral Anticoagulant Therapy for the American College of Chest Physicians Consensus Guidelines for Antithrombotic Therapy and is an associate editor of the Journal of Thrombosis and Thrombolysis. He also serves as an editorial consultant for numerous journals including the New England Journal of Medicine, Annals of Internal Medicine, Blood, and Thrombosis & Hemostasis.


Maybe she needs to be threatened that if the machine is taken away from you and poses an undo hardship based on her lack of knowledge and you stroke out, that your family is coming at her with a lawyer big time. You might want to email Al Lodwick about it. He may have some recommendations for you also.
Click to expand...

I hate to say this. I am a Kaiser doctor, radiologist( Falls ChurchVA), but I do not use them for my heart and anticoagulation monitoring. Why? Because,just within the last two months, one of their pharmacists told me with great certainty that home monitors were were totally unreliable. I did not want to argue with this very assured young lady, didn't have time over the phone.I was calling about another matter, one of our patients on warfarin scheduled for a breast biopsy.However I will print Ross's reponse and mail it to her. I did talk to the chief of our lab. She told me she thought home monitors were OK. They work well if the patient has faith in them and tests frequently.Our pharmacists need a lecture from our great pharmacist Al Lodwick.
 
Thank you Ross, I will try that but, I am not sure it will work at Kaiser because everyone refers you to the anticoagulation clinic. Oh, I just remembered my Cardio wouldn't give me script for the unit,he said they are dangerous and not reliable,. My Surgeon was going to write script by would not handle the anticoagulation end. my PCP did write script but I know he won't be bothered with anticoagulation.
 
Ross said:
Who owns the machine? If it's you, they can't do a thing about it. You just have a jackass to deal with. Tell her to call Dr.Jack Ansell in Boston and discuss her feelings about home testing with a professional physician who is a leading advocate for home testing or better yet, get the moron to watch the Discovery movie we have posted up top. They don't give credits for nothing!

Jack E. Ansell, M.D. is Professor of Medicine at Boston University School of Medicine and Vice Chairman for Clinical Affairs, Department of Medicine, at Boston University Medical Center.

Dr. Ansell received his medical degree from the University of Virginia School of Medicine. He completed his internship and residency in Internal Medicine at Tufts-New England Medical Center in Boston, and a fellowship in Hematology and Hemostasis at Boston University/Boston City Hospitals and the Boston VA Hospital. He is board certified in Internal Medicine and the subspecialty of Hematology.

Dr. Ansell's research has focused on the disciplines of Hemostasis and Thrombosis, especially in the areas of Thrombotic Disorders and Antithrombotic Therapy. He has had a continued interest and involvement in the application of new modes of delivering and monitoring anticoagulants, and particularly in the management of oral anticoagulant therapy. He has published extensively and lectured widely on these topics. He is the founder of the Anticoagulation Forum, a network of anticoagulation clinics throughout North America, and is a member of a number of professional organizations including the American College of Physicians (Fellow), American Society of Hematology, International Society of Thrombosis and Hemostasis and its Scientific Subcommittee on Anticoagulation Monitoring, American Heart Association, and American Medical Association. He Chairs the expert panel on Monitoring Oral Anticoagulant Therapy for the American College of Chest Physicians Consensus Guidelines for Antithrombotic Therapy and is an associate editor of the Journal of Thrombosis and Thrombolysis. He also serves as an editorial consultant for numerous journals including the New England Journal of Medicine, Annals of Internal Medicine, Blood, and Thrombosis & Hemostasis.


Maybe she needs to be threatened that if the machine is taken away from you and poses an undo hardship based on her lack of knowledge and you stroke out, that your family is coming at her with a lawyer big time. You might want to email Al Lodwick about it. He may have some recommendations for you also.
Click to expand...

Hi Ross, I have copied the info on Dr. Ansell along with the Discovery move info and I am sending it to everyone I have come in contact with over this subject at Kaiser. Maybe one, just one person will watch it.
 
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