How much for Coumadin Clinic - Hughes Syndrome A...

Hughes Syndrome APS Forum

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How much for Coumadin Clinic

christylee profile image
16 Replies

Hi, can those in the US, or elsewhere tell me how much they have to pay for a coumadin clinic visit. My clinic has been mis-coding lately and they are starting to charge me $50+ a visit. I need the information if you can to fight my case.

Thank you in advance.

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christylee profile image
christylee
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16 Replies
christylee profile image
christylee

Excuse me that is for me to fight my case

KellyInTexas profile image
KellyInTexasAdministrator

Hey Christylee,

My doctor has a standing order( Pt/ INR) for me at the lab at the actual hospital. We bypass our,” Coumadin clinic.”

The hospital offers a discount if you pay then and there. It amounts to $14.00 until in meet my out of pocket portion on my deductible.

Otherwise, if I went straight insurance policy ( Blue Cross Blue shield ) it wasn’t a whole lot more... maybe $21.00?

Once that is met- insurance picks it up at 100%

By the way... just a thought if you think you might benefit:

There are advantages for me of just getting a standing order through my GP at the hospital lab. I can pop in whenever needed. The ER has another lab that I can walk into ( without having to go actually register through the ER ) . My GP wrote a letter to accompany my standing order that says I need my INR results when the lab gets them, and that I myself can call and get them, or lab can call me. The letter states I have a blood clotting disorder and I need my results quickly so I can adjust my medications quickly. ( i.e. bridge with heparin!!!!!)

This has been a great solution for me, as my INR is so unstable and I clot so quickly.

MaryF profile image
MaryFAdministrator

Pleased to see you have the right person giving you an answer! MaryF

christylee profile image
christylee

I actually attend a coumadin clinic and don't have standing orders and my doctor would not want to compete with another organization within the hospital by doing something like that. Is there anyone who attends a coumadin clinic in the US who pays a copay or something?

I would really appreciate the information.

KellyInTexas profile image
KellyInTexasAdministrator in reply tochristylee

Sorry I couldn’t be of more help...

jetjetjet profile image
jetjetjet in reply tochristylee

I go to a clinic here in N.H. - and i have a series that i can walk in anytime for PT/INR - i ave finical aid for this - . If you have a learning hospital near you you can apply , it is based on your yearly income -so it's a sliding scale - i know others that have done this at a different % than i as i am 100% BUT it covered it for them, the copay because clinic is at hosp as is Lab drawing blood . Learning or teaching hosp. get federal funds so this is offered - i see residents doctors quite a bit but i don't mind we give them a fast start with them learning about our APS -- you know welcome to the world of us Sludge bloods !! check with your or other hosp near by . Let me know how it pans out . hope this is of value to you .

christylee profile image
christylee

Thank you for trying Kelly, it is just that I have to go to a coumadin clinic in order to get my prescription refilled, and so I need information from people who attend coumadin clinics. Unfortunately I am not a strong enough force to change my insurance plan or the system it works under. I am trying to see what the price of another coumadin clinic might be so that I can know. I do not know specific individuals in my insurance plan who attend my coumadin clinic to know whether I am being discriminated against.

jetjetjet profile image
jetjetjet in reply tochristylee

when i see some of my bils ,that are paid the lab is $300 to draw and result but i have never seen a cost for Cou. clinic I can ask my Nurse at the clinic today .

christylee profile image
christylee

Am I actually the only person on this message board in the United States who attends a coumadin clinic?

KellyInTexas profile image
KellyInTexasAdministrator in reply tochristylee

Why don’t you just call other cities and ask? They are often called anti coagulation clinics.

christylee profile image
christylee

As in my hospital,it is not the clinic itself that does the coding, it is the medical billing office of the organization - in my case a hospital that does it.My issue has arisen because the person now doing the coding is billing for the pharmacists providing the service,not the doctor that oversees the clinic as should be done. The billing office will not be"corrected." This is according to my insurance company.

I spent 3 hours of my 5 available hours for the month on the phone with my insurance company,and my own hospital won't provide me with that type of information.My only hope is to get the information from other patients in my situation - in a coumadin clinic.

I apologize for upsetting you all with my question, I will search for other coumadin clinic patients if I can find other thrombosis or maybe afib boards. Just people taking my drug and monitored through a coumadin clinic.

KayHimm profile image
KayHimm in reply tochristylee

Even more reason that they need to pass laws (have read they are being proposed) about providing cost transparency for medical tests in the U.S. Isn’t it ridiculous that you would have to post on a forum to find out the cost of a Coumadin clinic? I hope you get answers.

KellyInTexas profile image
KellyInTexasAdministrator

No problem at all, I’m certainly not upset! Just trying to help think from a different angle.

Good luck with it.

Tofino5 profile image
Tofino5

Hi ChristyLee, can you contact your doctors office and ask them to intervene on this ‘mid-coding ‘ issue? They would probably have more luck.

As to your question, my information is a bit old as I switched to a different anticoagulant in 2017. So if it is any help, here is my response to your question.

I was never able to get a letter such as KellyInTexas describes, but I did have a standing order at the lab, good for 6 months, then I or the lab would request a new order. The order was from my hemotologist, and I went to a lab near home.

I had health insurance, and if I remember correctly, they were billed about $34, and would pay the lab less than $2. (I won’t comment on that bit of information, just telling how it was). I didn’t pay anything to the lab.

The coumadin clinic would phone me later with the results and to tell me what to do.

You’ve been trying to fix this on your own and I think the doc’s office needs to step in and handle it. They know more about coding. Also sometimes the insurance company will tell you which is the proper code ... I wish you luck and please let us know how you progress with this. Anita in Colorado

Ylmom profile image
Ylmom

I am so new to all of this and this may sound so dumb...what does a Coumadin Clinic do? I am in the US as well. I live a very small town🙈

KellyInTexas profile image
KellyInTexasAdministrator

Blood dewars for INR values.

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