In Home Test

[Pat Hicks]

My insurance company approved my getting an in home kit. There were just 2 problems. #1: they had no "in network" suppliers of the machines. Okay it's only a one time price, I could handle that. But #2 stumped me. The supplies for 4 tests cost $70+. Since they were not considered prescription drugs, the insurance would not pay anything on the supplies. Therefore, even though I really do need an in home tester, (one reason being that my pro time yo-yos) I must continue to go to the doctor for the test about every 2 weeks from now on because insurance will help pay for that. Does anyone have some thoughts. I have really been frustrated. After all, this is a "rest of your life" thing.

Thanks for at least letting me vent!

 

[QAS]

QAS RESPONSE

QAS RESPONSE

Hello,

I'm sorry to hear about your insurance coverage, but I have an idea that may help you. Please call me at your nearest convenience and I'll explain.

Lance
QAS
800-298-4515 ext. 2865

 

[sbradham]

Pat,

At first I had trouble with my insurance company with the machine and the supplies. They finally approved it when I told them that if I could not get the machine that they would continue to pay for office visits at $88.00 each visit and sometimes at that time was two and three times a week. Once they looked at all the visits then they changed their minds and now they pay for all the supplies I need. I have not been to the doctor for a ProTime visit in six months. Last night I tested my blood and then I called the office this morning and then they called me back to let me know if I should leave my meds the same or change it and then they tell you when to test it again.

Good Luck, sometimes you just have to keep after them.

 

[Rain]

sometimes you just have to keep after them.. that's a very nice way of putting it.

sometimes you just have to keep after them.. that's a very nice way of putting it.

Pat,

I copied all kinds of pages off the internet showing there was no supplier ?in network? and sent them to my insurance company. They finally agreed and paid for my machine. THEN I had problem # 2.... they didn?t want to pay for my supplies because the code QAS uses was showing up as ?durable medical equipment? to them. FINALLY after lots of phone calls & FAXs I convinced them it was lab work and they started paying at 90%.

My problem now is.. even tho I have the SAME insurance ...they changed the company who handles the claims. (I have wierd insurance) Now I?m back to fighting about it again. I can't believe all the money we give them and still we have to fight tooth and nail to get the benefits we pay for.

You may have to get a letter from Lance & your doctor to prove to them its lab work and you have no 'in network supplier'. That's my next step.

Good Luck!

 

[ALCapshaw2]

Pat,

Does your insurance company have 'case workers' for 'special situations'? If so, see if you can enlist their aid in pleading your case.

I had a case worker for Cardiac Rehab. I asked her to check into coverage for Home Testing which she did. She discovered the company was 'looking at it' but had not made a decision. At that time, Medicare and a couple of other state carriers for my company had just added coverage. My case was used for appeal and became the first for my carrier in my state. It took a while but was worth the effort. Testing supplies becomes another issue as noted. DME is often only covered for 'in house' suppliers. Perhaps you can push one of them to form an agreement with QAS. One of the suppliers I was refered to made such an arrangement in a day or so.

Good luck!

'AL'