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sknydave

Well-known member
Joined
Jun 2, 2007
Messages
130
Location
Orlando, FL
Those of you who have home monitoring machines, how long did you have to wait for a decision on whether or not you were approved for the machine? I sent in the paperwork for a machine late in April and still haven't heard back! I've had to call a few times to make sure they haven't forgotten about me. They say it usually takes months? Is this true?

Thanks!
 
I just got home from hospital yesterday AVR. I spent a long time on phone today looking into home test kits... it was approved by my insurance ok by dr but The antiquagulation team at Brigham and Womens in Boston informed me the reason I could not get one was the manufacturer would not release the kit unless youhad been followed by lab for 3 months. So I was told to call back aat start of Dec and they would sent one out.
Dana
 
no wait

no wait

seems like you guys in the states are drowning in red tape.

the day after my operation the nurses came to my bed and said "we strongly recommend you get a roache coaguchek, order it on this 0800 number today and we will teach you how to use it tommorrow" qed.

so i phoned roache and it arrived in my room by 10.00 am the next morning and the nurse showed me how to use it in the afternoon.

the only approval required was my own; and that is exactly how it should be!

and i have never heard doctors, nurses etc here question its accuracy etc, everyone seems to think its a bloody marvel. i 100% trust my coaguchek and never go near a lab.

i am not trying to be a comedian, but have you tried phoning roache direct and buying one over the phone with your credit card? and if that fails, why not just import one yourself?
 
David:

Who is your insurance carrier? What vendor are you seeking to get a tester from?

What percentage of DME does your insurance carrier cover and is that across the top, or does it cover, say, 80% of "allowable" or some other such term? (That 80% was actually 60% in my case when Aetna reimbursed me for my INRatio I purchased in April 2008. I had the $$$ to buy it, which actually saved me about $400 in the long run, had I applied for billing to go to Aetna.)

Does the EOB detail how long to wait for approval/turndown on durable medical equipment? Aetna specifies about 6 weeks on reimbursement; I'm not sure how long it says for approval if I had gone through Aetna for the purchase and then paid a co-pay.

Call the vendor you are seeking to get the tester machine through and go up the food chain for information on the status of your application. There's enough of us here who have dealt with quite a few companies that we should be able to give you names of contacts at those companies.
 
It took me about 10 days to get it.

My Dr. called RX in to Raytel Cardiac.

Of course, my co-pay is so high, I'm looking at buying the thing outright. I figure after 2 years, I've paid for it already, and continuing to pay $50/mo copay is just stupid.

Depending upon what Raytel wants for my "used" unit, I may purchase elsewhere. Since my BIL is an MD, I'll likely ask him to order one at the physician price from some medical supply places ($758) and save a couple hundred bucks over the Amazon.com site ($989), much less the $1500 Raytel wants for a new one.
So...depending upon your insurance and your resources, it may be cheaper in the long run just to buy it outright, rather than "rent."
 
Thanks for the replies!

I have Avmed insurance and I'm trying to work through QAS.

My coverage is as follows:

Other Services
Ambulance services $100 copay; for emergency services; check with Plan for details
Allergy tests and treatments $10 copay for injections; $50 copay per course of testing
Durable medical equipment $50 copay; per episode of illness; limited to $500 per contract year

Does this mean I have to pay $50 a month like AgilityDog above does? That makes no sense to me. I'd rather just buy the machine.
 
sknydave said:
Thanks for the replies!

I have Avmed insurance and I'm trying to work through QAS.

My coverage is as follows:

Other Services
Ambulance services $100 copay; for emergency services; check with Plan for details
Allergy tests and treatments $10 copay for injections; $50 copay per course of testing
Durable medical equipment $50 copay; per episode of illness; limited to $500 per contract year

Does this mean I have to pay $50 a month like AgilityDog above does? That makes no sense to me. I'd rather just buy the machine.
Click to expand...

I don't interpret these well, but to me it says they'll pay $500 toward the machine, then you won't have any DME coverage until the beginning of the new year.
 
Somehow, I don't think that paragraph even applies, though I'm sure they'll try to make apply.
 
I'm wondering if they're figuring on casts, crutches, boots, etc.?

Dave:

Have you talked to a human employee of your insurance company? Talk to someone who can address exactly how much or even whether they will cover the cost of an INR machine.
 
westie said:
seems like you guys in the states are drowning in red tape.

the day after my operation the nurses came to my bed and said "we strongly recommend you get a roache coaguchek, order it on this 0800 number today and we will teach you how to use it tommorrow" qed.

so i phoned roache and it arrived in my room by 10.00 am the next morning and the nurse showed me how to use it in the afternoon.

the only approval required was my own; and that is exactly how it should be!

and i have never heard doctors, nurses etc here question its accuracy etc, everyone seems to think its a bloody marvel. i 100% trust my coaguchek and never go near a lab.

i am not trying to be a comedian, but have you tried phoning roache direct and buying one over the phone with your credit card? and if that fails, why not just import one yourself?
Click to expand...

Westie, You may be a little behind us culturally but you are way ahead of us medically!
 
I was very lucky. Mine arrived 8 hours post surgery while I was still in the Intensive Care Unit of the hospital here in Sydney, the nurses informed me it was a gift from my surgeon. Not only a great surgeon but a generous one.

Jeff.
 
Sorry for the late reply, I've been out of town. I will call tomorrow to (try) to speak to an actual person regarding the costs. I'm probably going to just purchase the machine on my own, though.
 
sknydave said:
Sorry for the late reply, I've been out of town. I will call tomorrow to (try) to speak to an actual person regarding the costs. I'm probably going to just purchase the machine on my own, though.
Click to expand...

Dave your in QAS's neighborhood, so give em a call. I know if you pay cash or the like and don't use insurance, the price is roughly half of what insurance is billed.
 
Ross said:
Dave your in QAS's neighborhood, so give em a call. I know if you pay cash or the like and don't use insurance, the price is roughly half of what insurance is billed.
Click to expand...

Heck, see if it's possible to pay a visit to QAS' offices and get a demonstration of the different machines!

I didn't see a price break on the CoaguChek at QAS' website. Kinda like All-Clad prohibiting a discount on its cookware at retailers. (Darn it!)
 
I finally got word today. QAS isn't even "in network" for Avmed. They told me that I should contact Raytel. The wait of several months was certainly worth it!
 
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