I have won my battle and am finally free

[mrcora]

Today was the final day that I was finally able to break free from the grips of the local Coumadin clinic. They were all very nice to me but after 7 years I was sick of going there. To cut a long story short:

• I bought two meters: Coagucehck XS and Vantus/INRange
• I tested this morning and the XS was 2.7 and the Vantus 2.9
• I went to the Coumadin clinic and then tested with their I-STAT1 machine and came out at 2.6

I then got on the phone with BioTel Remote INR to enroll. They proceeded to tell me that I had to get "trained" and that it would cost me 87 dollars. They then said since my deductible of 600 dollars had not been met yet this year, I had to pay $84.25 for 4 test strips and that I had to report to them every two weeks. After paying 84.25 for each 4 tests, when I finaly reach the 600 deductible, they would be "free." Gee what a great deal.

I was not happy.

I contacted my doctor's nurse and explained to her that I had seen all the Roache videos and knew how to self test myself and that I found it ridiculous that I had to sign up for that service just to get the strips. I told her that I would be buying my own strips and be done with it. I wanted my freedom and can handle self reporting.

They agreed and now I am free!

 

[pellicle]

Hi

I tested this morning and the XS was 2.7 and the Vantus 2.9

not a significant difference but (if I may)
were you using the same batch of strips (and thus moving the code chip between machines)?
Were you using this type of strips...

or this type?

I went to the Coumadin clinic and then tested with their I-STAT1 machine and came out at 2.6

2.6 and 2.7 are almost the same ... which is not uncommon from what I read

This is from an older study (back when Coaguchek S was around, so before the XS model)

I posted it in particular because of the comparison between i-Stat and lab ... so it shows similar variance

So, are you also self managing or will they still be doing your dosing?

Best Wishes

 

[mrcora]

Hi

not a significant difference but (if I may)
were you using the same batch of strips (and thus moving the code chip between machines)?
Were you using this type of strips...
View attachment 889807
or this type?
View attachment 889808


2.6 and 2.7 are almost the same ... which is not uncommon from what I read

This is from an older study (back when Coaguchek S was around, so before the XS model)
View attachment 889809
I posted it in particular because of the comparison between i-Stat and lab ... so it shows similar variance

So, are you also self managing or will they still be doing your dosing?

Best Wishes

I am using the first one: CoaguChek XS PT Test.

I first did it on the XS and then put the chip in the Vantus.

I will be doing my own dosing and reporting it every month to my doctors office online.

 

[pellicle]

I am using the first one: CoaguChek XS PT Test.

that "might" be the cause of the difference in the Vantus

 

[Chuck C]

Well done! Welcome to freedom!

Mrcora: I'm free!

Biotel: Sorry to tell you that freedom isn't free- pay us $600 per year.

Mrcora: Pound sand Biotel, I'm going over your head and reporting directly to my doctor's office.

I had a similar experience. When I bought my Coaguchek xs, the coumadin clinic asked me to report my weekly results to them each test. They would then usually tell me: " Good job, keep up the same dosing." It was all good. It's nice to get that little pat on the back and to be told that you're doing it correctly. Until about 6 weeks later when I realized they were charging $550 each time I sent them the results. This was the year of my surgery, so I was way over my deductible and none of it came out of my pocket. But, once my $10,500 deductible reset I would get hit with paying the bill. And, my insurance is a relatively small cost sharing group, and I certainly did not want them to keep getting screwed like that.

So, I did what you basically did. I asked my cardiologist if I could just report my numbers to him directly. All good. My only cost is about $18 per month for 4 strips.

Here's a coumadin clinic story. So, I'm managing myself for about 6 months and asked my cardiologist to put an INR draw order in at the lab so that I could confirm the accuracy of my meter.

The next day I get an urgent message from the coumadin clinic. It turns out that Quest lab still had instructions to send my results directly to the coumadin clinic. My result was 2.4 and the coumadin clinic had prescribed injectable Lovenox and told me to change my dosage to 4mg of warfarin. None of this made any sense, as my range was 2.0 to 3.0- my INR was ideal. And by now my dosage had increased to 6mg/day. Rather than just pick up the prescription and jab myself with the Lovenox, then paradoxically lower my warfarin from 6mg to 4mg, I called them to find out what in the world they were talking about. Turns out that they had not bothered to communicate with my cardiologist's office to learn that my INR range had been changed from 2.5 to 3.5 to 2.0 to 3.0. As far as they were aware, 2.4 INR meant that I was under what they thought was the low end of my range. The Lovenox? That was meant to bridge me while my INR got back in range. The funny thing is that by telling me to dose 4mg, instead of my normal 6mg, it would have insured that I stay under 2.5 INR. 6 months earlier, while I was under their guidance, my dosage was only 3.5mg, so they thought that they were increasing me by 0.5mg, when in fact their order was dropping my dosage by 2mg and would have eventually really got me into INR trouble. I guess if I didn't call them to sort things out I would still be injecting today, lol. It really makes my scratch my head that they took these steps, of writing the Lovenox prescription and changing my warfarin dose without communicating with my cardiologist's office. They had not been giving me guidance for 6 months and they just assumed that my range was the same and also by warfarin dosage.

So, always best to be your own advocate and question things when they look off, even if they are being handed down from an almighty coumadin clinic physician. Physicians are human- sometimes very human, and they too make errors. So, just always keep your thinking cap on and never be afraid to ask questions.

 

[Lynn]

Question, Does anyone else in other countries than the U.S send their home test results to a clinic or physician? I’m in Canada and I don’t. My GP suggested once that I send him results if I wanted, but I never did. Whenever I talk to my GP, cardio or have had a surgical procedure or ER visit, they simply ask me what my INR and my current dose is and we carry on. They all seem to think it’s great that I home test weekly.After all , it is self management.

Is it an insurance thing, or revenue grab? What Happens if you say no thanks, I’ll manage it myself?

You do need a prescription in BC to get a meter, which I thought was a bit of over control at the time, but nothing compared to what other folks are dealing with.

 

[pellicle]

Question, Does anyone else in other countries than the U.S send their home test results to a clinic or physician?

in Australia you can, but its a bit grey. There is no compulsion to do so, but there is a weird exemption to the "bulk billing" rules that allows you to pay an up front fee (something like $300) and work with a government approved lab. However you have to go into the lab "collection center" in order to get a sample as I understand it.

You do need a prescription in BC to get a meter, which I thought was a bit of over control at the time,

no such prescription required to pay cash (or use your card) for Roche Coaguchek and strips here (or in the EU I lived in Finland for some years)

Stores I've used:
https://www.doccheckshop.eu/search?sSearch=roche+coaguchek
https://www.medshop.com.au/products/coaguchek-xs-system-au

What Happens if you say no thanks, I’ll manage it myself?

Again in Australia and Finland nobody cares. Your Dr has to prescribe your warfarin and so you'll need to explain why and how and every single doctor has been somewhere between "ok, no problem" to "wow, that's really interesting, is it hard?"

I'll make no comments about the other topics because apparently discussing facts is called "America Bashing"

PS: if I lived in the US I'd probably vote Trump

Just kidding ... I probably wouldn't vote

 

[mrcora]

Well done! Welcome to freedom!

Mrcora: I'm free!

Biotel: Sorry to tell you that freedom isn't free- pay us $600 per year.

Mrcora: Pound sand Biotel, I'm going over your head and reporting directly to your doctor's office.

I had a similar experience. When I bought my Coaguchek xs, the coumadin clinic asked me to report my weekly results to them each test. They would then usually tell me: " Good job, keep up the same dosing." It was all good. It's nice to get that little pat on the back and to be told that you're doing it correctly. Until about 6 weeks later they were charging $550 each time I sent them the results. This was the year of my surgery, so I was way over my deductible and none of it came out of my pocket. But, once my $10,500 deductible reset I would get hit with paying the bill. And, my insurance is a relatively small cost sharing group, and I certainly did not want them to keep getting screwed like that.

So, I did what you basically did. I asked my cardiologist if I could just report my numbers to him directly. All good. My only cost is about $18 per month for 4 strips.

Here's a coumadin clinic story. So, I'm managing myself for about 6 months and asked my cardiologist to put an INR draw order in at the lab so that I could confirm the accuracy of my meter.

The next day I get an urgent message from the coumadin clinic. It turns out that Quest lab still had instructions to send my results directly to the coumadin clinic. My result was 2.4 and the coumadin clinic had prescribed injectable Lovenox and told me to change my dosage to 4mg of warfarin. None of this made any sense, as my range was 2.0 to 3.0- my INR was ideal. And by now my dosage had increased to 6mg/day. Rather than just pick up the prescription and jab myself with the Lovenox, then paradoxically lower my warfarin from 6mg to 4mg, I called them to find out what in the world they were talking about. Turns out that they had not bothered to communicate with my cardiologist's office to learn that my INR range had been changed from 2.5 to 3.5 to 2.0 to 3.0. As far as they were aware, 2.4 INR meant that I was under what they thought was the low end of my range. The Lovenox? That was meant to bridge me while my INR got back in range. The funny thing is that by telling me to dose 4mg, instead of my normal 6mg, it would have insured that I stay under 2.5 INR. 6 months earlier, while I was under their guidance, my dosage was only 3.5mg, so they thought that they were increasing me by 0.5mg, when in fact their order was dropping my dosage by 2mg and would have eventually really got me into INR trouble. I guess if I didn't call them to sort things out I would still be injecting today, lol. It really makes my scratch my head that they took these steps, of writing the Lovenox prescription and changing my warfarin dose without communicating with my cardiologist's office. They had not been giving me guidance for 6 months and they just assumed that my range was the same and also by warfarin dosage.

So, always best to be your own advocate and question things when they look off, even if they are being handed down from an almighty coumadin clinic physician. Physicians are human- sometimes very human, and they too make errors. So, just always keep your thinking cap on and never be afraid to ask questions.

Your story about the Coumadin clinic is a good reminder how that people should learn more abotu their own INR levels and upkeep.

Question: How do you get 4 strips for $18 month? Is your insurance covering it? I ask because that was the whole reason I was looking into going with a monitoring company. I thought they would just cover it but it just wasn't worth the hassle when I can just purchase 24 strips for around $120 online on my own and be done with it.

I can't understand how an insurance company can cover prescriptions for thousands of dollars yet wont pay for 24 test strips. By me doing my own testing & buying my own machine, I actually save them thousands of dollars a year now.

 

[pellicle]

Your story about the Coumadin clinic is a good reminder how that people should learn more abotu their own INR levels and upkeep.

Agreed

It's not even hard. For anyone tempted to try (even if just to run a parallel test reach out and I'll set you up with a Google Sheet)

By me doing my own testing & buying my own machine, I actually save them thousands of dollars a year now.

Yep, the only losers are the labs. Maybe there's something financial in that...

 

[Chuck C]

Question: How do you get 4 strips for $18 month?

I buy my strips on Ebay. I've never had an issue doing it this way. I typically end up paying about $4.50/strip, because I buy them now in batches of 48. It ends up being closer to $5/strip when you just buy 24. I always make sure that there is over 12 months left before the expiration date of the strips. Any seller that does not tell you the expiration date upfront, I would stear clear of.

I can't understand how an insurance company can cover prescriptions for thousands of dollars yet wont pay for 24 test strips

There is not much logic with so many aspects of our medical system.

 

[slipkid]

Today was the final day that I was finally able to break free from the grips of the local Coumadin clinic. They were all very nice to me but after 7 years I was sick of going there. To cut a long story short:

• I bought two meters: Coagucehck XS and Vantus/INRange
• I tested this morning and the XS was 2.7 and the Vantus 2.9
• I went to the Coumadin clinic and then tested with their I-STAT1 machine and came out at 2.6

I then got on the phone with BioTel Remote INR to enroll. They proceeded to tell me that I had to get "trained" and that it would cost me 87 dollars. They then said since my deductible of 600 dollars had not been met yet this year, I had to pay $84.25 for 4 test strips and that I had to report to them every two weeks. After paying 84.25 for each 4 tests, when I finaly reach the 600 deductible, they would be "free." Gee what a great deal.

I was not happy.

I contacted my doctor's nurse and explained to her that I had seen all the Roache videos and knew how to self test myself and that I found it ridiculous that I had to sign up for that service just to get the strips. I told her that I would be buying my own strips and be done with it. I wanted my freedom and can handle self reporting.

They agreed and now I am free!

Congrats, good for you.

And I'm especially glad you did not get roped into Biotel Heart's orbit (which includes other names like Cardionet, Philips, Biotelemtry and some others I cannot recall). Their billing dept is not only incompetent but they (the company) are crooks as well. Avoid at all costs....

 

[slipkid]

Question, Does anyone else in other countries than the U.S send their home test results to a clinic or physician?

My current GP (who is a good for nothing lazy ass with a priority of leaning towards anything to give him less work - including not following up on anything that he should) does not want me sending him my INR test results (that would require him to spend 5 minutes a week looking them over I suppose).

 

[pellicle]

who is a good for nothing lazy ass with a priority of leaning towards anything to give him less work

I believe you've described a good 50% of humanity right there ... but I of course could be wrong.
PS: 57 word sentence perhaps gets you in the top 10; well done sir

 

[V__]

I believe you've described a good 50% of humanity right there ... but I of course could be wrong.

IMHO this is a huge underestimate. But then, I suspect you are a kind and optimistic person. Kind of matches my cultural stereotype about the Australians.

 

[Chuck C]

I suspect you are a kind and optimistic person.

@pellicle is indeed all rainbows and unicorns.

 

[pellicle]

Kind of matches my cultural stereotype about the Australians.

Especially from Queensland. We're a natural fit with Finns (which is why I married one).

A good example, in Savo they say "comprehension is the responsibility of the listener"