Guest guest Posted November 8, 2011 Report Share Posted November 8, 2011 It has been over 10 years since I was dealing with what was covered by Medicare. Was doing this for my mother and father. At that time many things that providers said were not covered in fact were. You should do your own reseach might take some searching but should be able to find reasons why someting is or is not covered. How does one talk to the government? Try writing to who you put in office. > > > > Health care via government committee? Nice! Doctors are becoming nothing > > more than " fill in the box " robots. > > > > Val > > > > From: hyperaldosteronism > <mailto:hyperaldosteronism%40yahoogroups.com> > > [mailto:hyperaldosteronism > <mailto:hyperaldosteronism%40yahoogroups.com> ] On Behalf Of > > > > > > You are partially right in the fact that they have a limited supply in > stock > > if any. The other side as I understand it is that an RX has to go thru a > > review process or can only be RXed by certain doctors. Cymbalta is or > > atleast was non-formulary when I was RXed. My therapist, a Nurse > Practioner, > > was denied the first time because the wanted me off the narcotics because > > they thought I wouldn't need them. I refused unless I KNEW Cymbalta would > > take care of the pain. The NP, Barbra Bonney, agreed with me and took it > to > > some commitee and they reversed the decision. (Barbra formed the " new " > > in-home care program and is in charge of it!) > > > > > > . > > Web Bug from > > > http://geo.yahoo.com/serv?s=97359714/grpId=7299303/grpspId=1705132763/msgId= > > 37921/stime=1320680452/nc1=5191951/nc2=5191947/nc3=3848640 > > <http://www.mailscanner.tv/1x1spacer.gif> > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 8, 2011 Report Share Posted November 8, 2011 My wife had just the opposite, she went to her PCP for her " free " annual physical. Being a single doctor office he sent her to the local hospital for labs and testing. We ended up paying over $600 because it was applied to deductible. Had they been done in his office charges would have beeen included as part of the physical! Talk about a scam, how many small doctor's offices are set up to do their own labs, especially when their office is located in the professional office bld. attached to the hospital! ..... > > > > Health care via government committee? Nice! Doctors are becoming nothing > > more than " fill in the box " robots. > > > > Val > > > > From: hyperaldosteronism > <mailto:hyperaldosteronism%40yahoogroups.com> > > [mailto:hyperaldosteronism > <mailto:hyperaldosteronism%40yahoogroups.com> ] On Behalf Of > > > > > > You are partially right in the fact that they have a limited supply in > stock > > if any. The other side as I understand it is that an RX has to go thru a > > review process or can only be RXed by certain doctors. Cymbalta is or > > atleast was non-formulary when I was RXed. My therapist, a Nurse > Practioner, > > was denied the first time because the wanted me off the narcotics because > > they thought I wouldn't need them. I refused unless I KNEW Cymbalta would > > take care of the pain. The NP, Barbra Bonney, agreed with me and took it > to > > some commitee and they reversed the decision. (Barbra formed the " new " > > in-home care program and is in charge of it!) > > > > > > . > > Web Bug from > > > http://geo.yahoo.com/serv?s=97359714/grpId=7299303/grpspId=1705132763/msgId= > > 37921/stime=1320680452/nc1=5191951/nc2=5191947/nc3=3848640 > > <http://www.mailscanner.tv/1x1spacer.gif> > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 8, 2011 Report Share Posted November 8, 2011 They dont have to think. It's in the guidelines. They just have to read. It's actually very simple. Low K, resistant HTN = red flag. But if no low K and still resistant than check still. They just don't. Looking for a pheo is more exciting Subject: RE: Re: Neperologist Appt. UpdateTo: hyperaldosteronism Date: Monday, November 7, 2011, 11:07 PM Ahh, but the PA boxes are still not there to check. To dx PA, doctors have to think + have attended class that day. Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Clarence Grim On the check the box robot dr my guess most would not be here soars in the process if the boxes had been checked years ago. But hey we do not want to interfere with a Drs right to do what s/he wants without being a boxer. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 8, 2011 Report Share Posted November 8, 2011 How do I talk to the government? I wrote to Sen. Bernie , the Independent senator from Vermont who is on the Veterans Affairs Committee, when the VA said I should be supplied 15 lb. oxygen tanks instead of a 5 lb portable concentrator. (Cost $557/mo for tanks and <$3000 one time for concentrator so not only is it more concient, it's less expensive!) His right hand man took the issue and got an answer back that it was the provider's choice. He basically went back and said that was B.S. to try again! Still waiting for second response. Of course I no longer require supplemental oxygen and the doctor that denied mke died of a heart attack so it may never get resolved! ..... > > > > Health care via government committee? Nice! Doctors are becoming nothing > > more than " fill in the box " robots. > > > > Val > > > > From: hyperaldosteronism > <mailto:hyperaldosteronism%40yahoogroups.com> > > [mailto:hyperaldosteronism > <mailto:hyperaldosteronism%40yahoogroups.com> ] On Behalf Of > > > > > > You are partially right in the fact that they have a limited supply in > stock > > if any. The other side as I understand it is that an RX has to go thru a > > review process or can only be RXed by certain doctors. Cymbalta is or > > atleast was non-formulary when I was RXed. My therapist, a Nurse > Practioner, > > was denied the first time because the wanted me off the narcotics because > > they thought I wouldn't need them. I refused unless I KNEW Cymbalta would > > take care of the pain. The NP, Barbra Bonney, agreed with me and took it > to > > some commitee and they reversed the decision. (Barbra formed the " new " > > in-home care program and is in charge of it!) > > > > > > . > > Web Bug from > > > http://geo.yahoo.com/serv?s=97359714/grpId=7299303/grpspId=1705132763/msgId= > > 37921/stime=1320680452/nc1=5191951/nc2=5191947/nc3=3848640 > > <http://www.mailscanner.tv/1x1spacer.gif> > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 8, 2011 Report Share Posted November 8, 2011 The only thing missing in my case is the box, the comment is there in the lab report! (RENIN: 0.1L Primary aldosteronsim possible: <0.65) Maybe I'll suggest they show out of range numbers in red! Then we could require a doctor to initial all red numbers! - 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with Meds. And DASH. . Current BP(last week ave): 131/76 HR 60 Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, and PTSD. Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50 MG. > > Ahh, but the PA boxes are still not there to check. To dx PA, doctors have to think + have attended class that day. > > Val > > From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Clarence Grim > > On the check the box robot dr my guess most would not be here soars in the process if the boxes had been checked years ago. But hey we do not want to interfere with a Drs right to do what s/he wants without being a boxer. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 8, 2011 Report Share Posted November 8, 2011 Box 8: No/Low renin-test for PA - 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with Meds. And DASH. . Current BP(last week ave): 131/76 HR 60 Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, and PTSD. Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50 MG. > > > > From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of > > You are partially right in the fact that they have a limited supply in stock if any. The other side as I understand it is that an RX has to go thru a review process or can only be RXed by certain doctors. Cymbalta is or atleast was non-formulary when I was RXed. My therapist, a Nurse Practioner, was denied the first time because the wanted me off the narcotics because they thought I wouldn't need them. I refused unless I KNEW Cymbalta would take care of the pain. The NP, Barbra Bonney, agreed with me and took it to some commitee and they reversed the decision. (Barbra formed the " new " in-home care program and is in charge of it!) > > > > > > . > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 8, 2011 Report Share Posted November 8, 2011 They can draw blood and have it picked up in any office.CE Grim MD My wife had just the opposite, she went to her PCP for her "free" annual physical. Being a single doctor office he sent her to the local hospital for labs and testing. We ended up paying over $600 because it was applied to deductible. Had they been done in his office charges would have beeen included as part of the physical! Talk about a scam, how many small doctor's offices are set up to do their own labs, especially when their office is located in the professional office bld. attached to the hospital! .... > > > > Health care via government committee? Nice! Doctors are becoming nothing > > more than "fill in the box" robots. > > > > Val > > > > From: hyperaldosteronism > <mailto:hyperaldosteronism%40yahoogroups.com> > > [mailto:hyperaldosteronism > <mailto:hyperaldosteronism%40yahoogroups.com> ] On Behalf Of > > > > > > You are partially right in the fact that they have a limited supply in > stock > > if any. The other side as I understand it is that an RX has to go thru a > > review process or can only be RXed by certain doctors. Cymbalta is or > > atleast was non-formulary when I was RXed. My therapist, a Nurse > Practioner, > > was denied the first time because the wanted me off the narcotics because > > they thought I wouldn't need them. I refused unless I KNEW Cymbalta would > > take care of the pain. The NP, Barbra Bonney, agreed with me and took it > to > > some commitee and they reversed the decision. (Barbra formed the "new" > > in-home care program and is in charge of it!) > > > > > > . > > Web Bug from > > > http://geo.yahoo.com/serv?s=97359714/grpId=7299303/grpspId=1705132763/msgId= > > 37921/stime=1320680452/nc1=5191951/nc2=5191947/nc3=3848640 > > <http://www.mailscanner.tv/1x1spacer.gif> > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 8, 2011 Report Share Posted November 8, 2011 God speaks? to the denier?CE Grim MD How do I talk to the government? I wrote to Sen. Bernie , the Independent senator from Vermont who is on the Veterans Affairs Committee, when the VA said I should be supplied 15 lb. oxygen tanks instead of a 5 lb portable concentrator. (Cost $557/mo for tanks and <$3000 one time for concentrator so not only is it more concient, it's less expensive!) His right hand man took the issue and got an answer back that it was the provider's choice. He basically went back and said that was B.S. to try again! Still waiting for second response. Of course I no longer require supplemental oxygen and the doctor that denied mke died of a heart attack so it may never get resolved! .... > > > > Health care via government committee? Nice! Doctors are becoming nothing > > more than "fill in the box" robots. > > > > Val > > > > From: hyperaldosteronism > <mailto:hyperaldosteronism%40yahoogroups.com> > > [mailto:hyperaldosteronism > <mailto:hyperaldosteronism%40yahoogroups.com> ] On Behalf Of > > > > > > You are partially right in the fact that they have a limited supply in > stock > > if any. The other side as I understand it is that an RX has to go thru a > > review process or can only be RXed by certain doctors. Cymbalta is or > > atleast was non-formulary when I was RXed. My therapist, a Nurse > Practioner, > > was denied the first time because the wanted me off the narcotics because > > they thought I wouldn't need them. I refused unless I KNEW Cymbalta would > > take care of the pain. The NP, Barbra Bonney, agreed with me and took it > to > > some commitee and they reversed the decision. (Barbra formed the "new" > > in-home care program and is in charge of it!) > > > > > > . > > Web Bug from > > > http://geo.yahoo.com/serv?s=97359714/grpId=7299303/grpspId=1705132763/msgId= > > 37921/stime=1320680452/nc1=5191951/nc2=5191947/nc3=3848640 > > <http://www.mailscanner.tv/1x1spacer.gif> > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 8, 2011 Report Share Posted November 8, 2011 We need to get this in the VA system as they prob seem more HTN than any other practice in the world. I will work on it next time I am in the system and will also talk to some folks I know in the VA system.CE Grim MD The only thing missing in my case is the box, the comment is there in the lab report! (RENIN: 0.1L Primary aldosteronsim possible: <0.65) Maybe I'll suggest they show out of range numbers in red! Then we could require a doctor to initial all red numbers! - 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with Meds. And DASH. . Current BP(last week ave): 131/76 HR 60 Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, and PTSD. Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50 MG. > > Ahh, but the PA boxes are still not there to check. To dx PA, doctors have to think + have attended class that day. > > Val > > From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Clarence Grim > > On the check the box robot dr my guess most would not be here soars in the process if the boxes had been checked years ago. But hey we do not want to interfere with a Drs right to do what s/he wants without being a boxer. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 8, 2011 Report Share Posted November 8, 2011 But why would you if the lab is right next door. And would ins./medicare pay the doctor an extra $25 for supplies and handling? Would you prefer someone who draws 3-4 times a week or someone who draws 100+ times a day? I once told a Red Cross tech. that I would pass out if she started " mining " . Her response, " I don't miss " and sye didn't! - 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with Meds. And DASH. . Current BP(last week ave): 131/76 HR 60 Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, and PTSD. Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50 MG. > > > > > > > > Health care via government committee? Nice! Doctors are becoming > > nothing > > > > more than " fill in the box " robots. > > > > > > > > Val > > > > > > > > From: hyperaldosteronism > > > <mailto:hyperaldosteronism%40yahoogroups.com> > > > > [mailto:hyperaldosteronism > > > <mailto:hyperaldosteronism%40yahoogroups.com> ] On Behalf Of > > > > > > > > > > > > > > You are partially right in the fact that they have a limited > > supply in > > > stock > > > > if any. The other side as I understand it is that an RX has to > > go thru a > > > > review process or can only be RXed by certain doctors. Cymbalta > > is or > > > > atleast was non-formulary when I was RXed. My therapist, a Nurse > > > Practioner, > > > > was denied the first time because the wanted me off the > > narcotics because > > > > they thought I wouldn't need them. I refused unless I KNEW > > Cymbalta would > > > > take care of the pain. The NP, Barbra Bonney, agreed with me and > > took it > > > to > > > > some commitee and they reversed the decision. (Barbra formed the > > " new " > > > > in-home care program and is in charge of it!) > > > > > > > > > > > > . > > > > Web Bug from > > > > > > > http://geo.yahoo.com/serv?s=97359714/grpId=7299303/grpspId=1705132763/msgId= > > > > 37921/stime=1320680452/nc1=5191951/nc2=5191947/nc3=3848640 > > > > <http://www.mailscanner.tv/1x1spacer.gif> > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 8, 2011 Report Share Posted November 8, 2011 Don't blame me, I prefer to think he was self-medicating - then he has only himself to blame! - 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with Meds. And DASH. . Current BP(last week ave): 131/76 HR 60 Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, and PTSD. Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50 MG. > > > > > > > > Health care via government committee? Nice! Doctors are becoming > > nothing > > > > more than " fill in the box " robots. > > > > > > > > Val > > > > > > > > From: hyperaldosteronism > > > <mailto:hyperaldosteronism%40yahoogroups.com> > > > > [mailto:hyperaldosteronism > > > <mailto:hyperaldosteronism%40yahoogroups.com> ] On Behalf Of > > > > > > > > > > > > > > You are partially right in the fact that they have a limited > > supply in > > > stock > > > > if any. The other side as I understand it is that an RX has to > > go thru a > > > > review process or can only be RXed by certain doctors. Cymbalta > > is or > > > > atleast was non-formulary when I was RXed. My therapist, a Nurse > > > Practioner, > > > > was denied the first time because the wanted me off the > > narcotics because > > > > they thought I wouldn't need them. I refused unless I KNEW > > Cymbalta would > > > > take care of the pain. The NP, Barbra Bonney, agreed with me and > > took it > > > to > > > > some commitee and they reversed the decision. (Barbra formed the > > " new " > > > > in-home care program and is in charge of it!) > > > > > > > > > > > > . > > > > Web Bug from > > > > > > > http://geo.yahoo.com/serv?s=97359714/grpId=7299303/grpspId=1705132763/msgId= > > > > 37921/stime=1320680452/nc1=5191951/nc2=5191947/nc3=3848640 > > > > <http://www.mailscanner.tv/1x1spacer.gif> > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 8, 2011 Report Share Posted November 8, 2011 Our program we use WRS practice management flashes all vitals that are abnormal in red - forever. Problem is they are not on the front form, so you have to actually check vitals. I suspect many get to doing things and do not actually look at the vitals The only thing missing in my case is the box, the comment is there in the lab report! (RENIN: 0.1L Primary aldosteronsim possible: <0.65)Maybe I'll suggest they show out of range numbers in red! Then we could require a doctor to initial all red numbers! - 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with Meds. And DASH. . Current BP(last week ave): 131/76 HR 60Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, and PTSD.Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50 MG. >> Ahh, but the PA boxes are still not there to check. To dx PA, doctors have to think + have attended class that day.> > Val> > From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Clarence Grim> > On the check the box robot dr my guess most would not be here soars in the process if the boxes had been checked years ago. But hey we do not want to interfere with a Drs right to do what s/he wants without being a boxer.> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 8, 2011 Report Share Posted November 8, 2011 Most insurances wont pay for a sleep study, but will years of CHF and HTN management and even a heart transplant. So much for preventive care. How do I talk to the government? I wrote to Sen. Bernie , the Independent senator from Vermont who is on the Veterans Affairs Committee, when the VA said I should be supplied 15 lb. oxygen tanks instead of a 5 lb portable concentrator. (Cost $557/mo for tanks and <$3000 one time for concentrator so not only is it more concient, it's less expensive!)His right hand man took the issue and got an answer back that it was the provider's choice. He basically went back and said that was B.S. to try again! Still waiting for second response. Of course I no longer require supplemental oxygen and the doctor that denied mke died of a heart attack so it may never get resolved!....> >> > Health care via government committee? Nice! Doctors are becoming nothing> > more than "fill in the box" robots.> > > > Val> > > > From: hyperaldosteronism > <mailto:hyperaldosteronism%40yahoogroups.com> > > [mailto:hyperaldosteronism > <mailto:hyperaldosteronism%40yahoogroups.com> ] On Behalf Of > > > > > > You are partially right in the fact that they have a limited supply in> stock> > if any. The other side as I understand it is that an RX has to go thru a> > review process or can only be RXed by certain doctors. Cymbalta is or> > atleast was non-formulary when I was RXed. My therapist, a Nurse> Practioner,> > was denied the first time because the wanted me off the narcotics because> > they thought I wouldn't need them. I refused unless I KNEW Cymbalta would> > take care of the pain. The NP, Barbra Bonney, agreed with me and took it> to> > some commitee and they reversed the decision. (Barbra formed the "new"> > in-home care program and is in charge of it!)> > > > > > .> > Web Bug from> >> http://geo.yahoo.com/serv?s=97359714/grpId=7299303/grpspId=1705132763/msgId=> > 37921/stime=1320680452/nc1=5191951/nc2=5191947/nc3=3848640> > <http://www.mailscanner.tv/1x1spacer.gif>> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 8, 2011 Report Share Posted November 8, 2011 Dont pay your taxes. Then they'll talk to you more than you want. Subject: Re: Neperologist Appt. UpdateTo: hyperaldosteronism Date: Tuesday, November 8, 2011, 9:34 AM How do I talk to the government? I wrote to Sen. Bernie , the Independent senator from Vermont who is on the Veterans Affairs Committee, when the VA said I should be supplied 15 lb. oxygen tanks instead of a 5 lb portable concentrator. (Cost $557/mo for tanks and <$3000 one time for concentrator so not only is it more concient, it's less expensive!)His right hand man took the issue and got an answer back that it was the provider's choice. He basically went back and said that was B.S. to try again! Still waiting for second response. Of course I no longer require supplemental oxygen and the doctor that denied mke died of a heart attack so it may never get resolved!....> >> > Health care via government committee? Nice! Doctors are becoming nothing> > more than "fill in the box" robots.> > > > Val> > > > From: hyperaldosteronism > <mailto:hyperaldosteronism%40yahoogroups.com> > > [mailto:hyperaldosteronism > <mailto:hyperaldosteronism%40yahoogroups.com> ] On Behalf Of > > > > > > You are partially right in the fact that they have a limited supply in> stock> > if any. The other side as I understand it is that an RX has to go thru a> > review process or can only be RXed by certain doctors. Cymbalta is or> > atleast was non-formulary when I was RXed. My therapist, a Nurse> Practioner,> > was denied the first time because the wanted me off the narcotics because> > they thought I wouldn't need them. I refused unless I KNEW Cymbalta would> > take care of the pain. The NP, Barbra Bonney, agreed with me and took it> to> > some commitee and they reversed the decision. (Barbra formed the "new"> > in-home care program and is in charge of it!)> > > > > > .> > Web Bug from> >> http://geo.yahoo.com/serv?s=97359714/grpId=7299303/grpspId=1705132763/msgId=> > 37921/stime=1320680452/nc1=5191951/nc2=5191947/nc3=3848640> > <http://www.mailscanner.tv/1x1spacer.gif>> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 8, 2011 Report Share Posted November 8, 2011 Rest assured, I plan to address it directly from the patient perspective once I get through my disability claim. I may even " float the whole boat " and file a missed DX claim, if nothing else it should catch some attention if I can explain the progression and regression in the 3 1/2 years it was missed that I can actually document! If that doesn't float the first time, won't Sen. Bernie be impressed - he loves his Vets! - 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with Meds. And DASH. . Current BP(last week ave): 131/76 HR 60 Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, and PTSD. Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50 MG. > > > > > > Ahh, but the PA boxes are still not there to check. To dx PA, > > doctors have to think + have attended class that day. > > > > > > Val > > > > > > From: hyperaldosteronism [mailto:hyperaldosteronism > > ] On Behalf Of Clarence Grim > > > > > > On the check the box robot dr my guess most would not be here > > soars in the process if the boxes had been checked years ago. But > > hey we do not want to interfere with a Drs right to do what s/he > > wants without being a boxer. > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 8, 2011 Report Share Posted November 8, 2011 Box 8: OSA and HTN-test for PA would have gotten you as I recall.Working on check list now up to 30+. Box 8: No/Low renin-test for PA - 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with Meds. And DASH. . Current BP(last week ave): 131/76 HR 60 Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, and PTSD. Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50 MG. > > > > From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of > > You are partially right in the fact that they have a limited supply in stock if any. The other side as I understand it is that an RX has to go thru a review process or can only be RXed by certain doctors. Cymbalta is or atleast was non-formulary when I was RXed. My therapist, a Nurse Practioner, was denied the first time because the wanted me off the narcotics because they thought I wouldn't need them. I refused unless I KNEW Cymbalta would take care of the pain. The NP, Barbra Bonney, agreed with me and took it to some commitee and they reversed the decision. (Barbra formed the "new" in-home care program and is in charge of it!) > > > > > > . > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 8, 2011 Report Share Posted November 8, 2011 Rest assured, I plan to address it directly from the patient perspective once I get through my disability claim. I may even "float the whole boat" and file a missed DX claim, if nothing else it should catch some attention if I can explain the progression and regression in the 3 1/2 years it was missed that I can actually document! If that doesn't float the first time, won't Sen. Bernie be impressed - he loves his Vets! - 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with Meds. And DASH. . Current BP(last week ave): 131/76 HR 60 Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, and PTSD. Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50 MG. > > > > > > Ahh, but the PA boxes are still not there to check. To dx PA, > > doctors have to think + have attended class that day. > > > > > > Val > > > > > > From: hyperaldosteronism [mailto:hyperaldosteronism > > ] On Behalf Of Clarence Grim > > > > > > On the check the box robot dr my guess most would not be here > > soars in the process if the boxes had been checked years ago. But > > hey we do not want to interfere with a Drs right to do what s/he > > wants without being a boxer. > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 8, 2011 Report Share Posted November 8, 2011 If I was programming it I would make you initial the flashing red before I would let you close it out! Then I would know it had been looked at and PTN would know who screwed them over! Maybe they should raise ALL abnormals to the top of the panel so you had to really ignore them to get to what you are looking for (and if there is a " normal " sequence simply list them twice!) , make that suggestion and put 1 or 2 of those kids thru college! If it saves one life or one malpractice suit it should be worth a college education expense! - 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with Meds. And DASH. . Current BP(last week ave): 131/76 HR 60 Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, and PTSD. Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50 MG. > > > > Ahh, but the PA boxes are still not there to check. To dx PA, doctors have to think + have attended class that day. > > > > Val > > > > From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Clarence Grim > > > > On the check the box robot dr my guess most would not be here soars in the process if the boxes had been checked years ago. But hey we do not want to interfere with a Drs right to do what s/he wants without being a boxer. > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 8, 2011 Report Share Posted November 8, 2011 But medicare will pay. > > > > > > Health care via government committee? Nice! Doctors are becoming nothing > > > more than " fill in the box " robots. > > > > > > Val > > > > > > From: hyperaldosteronism > > <mailto:hyperaldosteronism%40yahoogroups.com> > > > [mailto:hyperaldosteronism > > <mailto:hyperaldosteronism%40yahoogroups.com> ] On Behalf Of > > > > > > > > > You are partially right in the fact that they have a limited supply in > > stock > > > if any. The other side as I understand it is that an RX has to go thru a > > > review process or can only be RXed by certain doctors. Cymbalta is or > > > atleast was non-formulary when I was RXed. My therapist, a Nurse > > Practioner, > > > was denied the first time because the wanted me off the narcotics because > > > they thought I wouldn't need them. I refused unless I KNEW Cymbalta would > > > take care of the pain. The NP, Barbra Bonney, agreed with me and took it > > to > > > some commitee and they reversed the decision. (Barbra formed the " new " > > > in-home care program and is in charge of it!) > > > > > > > > > . > > > Web Bug from > > > > > http://geo.yahoo.com/serv?s=97359714/grpId=7299303/grpspId=1705132763/msgId= > > > 37921/stime=1320680452/nc1=5191951/nc2=5191947/nc3=3848640 > > > <http://www.mailscanner.tv/1x1spacer.gif> > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 8, 2011 Report Share Posted November 8, 2011 My insurance paid for 3, 1 before I went to the VA and then reimbursed VA for the last 2. > > > > > > > > Health care via government committee? Nice! Doctors are becoming nothing > > > > more than " fill in the box " robots. > > > > > > > > Val > > > > > > > > From: hyperaldosteronism > > > <mailto:hyperaldosteronism%40yahoogroups.com> > > > > [mailto:hyperaldosteronism > > > <mailto:hyperaldosteronism%40yahoogroups.com> ] On Behalf Of > > > > > > > > > > > > You are partially right in the fact that they have a limited supply in > > > stock > > > > if any. The other side as I understand it is that an RX has to go thru a > > > > review process or can only be RXed by certain doctors. Cymbalta is or > > > > atleast was non-formulary when I was RXed. My therapist, a Nurse > > > Practioner, > > > > was denied the first time because the wanted me off the narcotics because > > > > they thought I wouldn't need them. I refused unless I KNEW Cymbalta would > > > > take care of the pain. The NP, Barbra Bonney, agreed with me and took it > > > to > > > > some commitee and they reversed the decision. (Barbra formed the " new " > > > > in-home care program and is in charge of it!) > > > > > > > > > > > > . > > > > Web Bug from > > > > > > > http://geo.yahoo.com/serv?s=97359714/grpId=7299303/grpspId=1705132763/msgId= > > > > 37921/stime=1320680452/nc1=5191951/nc2=5191947/nc3=3848640 > > > > <http://www.mailscanner.tv/1x1spacer.gif> > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 8, 2011 Report Share Posted November 8, 2011 I can tell you it will likey do little good to file a missed DX with the VA claim. Might find this of some interest. http://www.va.gov/vetapp09/Files2/0919380.txt > > > > > > > > Ahh, but the PA boxes are still not there to check. To dx PA, > > > doctors have to think + have attended class that day. > > > > > > > > Val > > > > > > > > From: hyperaldosteronism [mailto:hyperaldosteronism > > > ] On Behalf Of Clarence Grim > > > > > > > > On the check the box robot dr my guess most would not be here > > > soars in the process if the boxes had been checked years ago. But > > > hey we do not want to interfere with a Drs right to do what s/he > > > wants without being a boxer. > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 8, 2011 Report Share Posted November 8, 2011 You may also want to read more here. http://www.index.va.gov/search/va/bva_search.jsp?QT=hyperaldosteronism & SQ= & RPP=1\ 0 & UA=Search > > > > > > > > > > Ahh, but the PA boxes are still not there to check. To dx PA, > > > > doctors have to think + have attended class that day. > > > > > > > > > > Val > > > > > > > > > > From: hyperaldosteronism [mailto:hyperaldosteronism > > > > ] On Behalf Of Clarence Grim > > > > > > > > > > On the check the box robot dr my guess most would not be here > > > > soars in the process if the boxes had been checked years ago. But > > > > hey we do not want to interfere with a Drs right to do what s/he > > > > wants without being a boxer. > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 8, 2011 Report Share Posted November 8, 2011 I appreciate your input however I think my situation is different. There is a sop that says if arr is greater than 25 or 30 something should happen. On 2/22/2007 arr was 50 and nothing happened. I have a lab report that says if renin is < 65 something should be checked. On 2/22/2007 my renin was 0.1 and nothing happened. On 12/10/2010 there is a ct-scan that was compared to a previous ct-scan done on 11/8/2005. 2nd finding: " There is a 13 x 12 mm circumscribed ovoid hypoattenuating leison in the right gland without interval change in size since prior study. " Was there a tumor in 2005? Did they do anything about it or even acknowledge it before 2010? Can I show that OSA worsened since 2007? Can I show that I was treated with suppl. oxygen since 2007 for 15 months and we now know it was caused by LVH, another situation they missed? (Who said COPD, let's see what the next PFT says!) They might be right but they better hope it doesn't go above 65% since I understand COPD does not get better! Can I show I was DXed w/T2DM since 2007? Can I show documentation and studies that link all the above to PA? Will I win? YES! Will I win $$$? Who knows/who cares? My goal in life is to leave this world better than I found it. If I can make it so only 1 veteran doesn't suffer like and as long as I have, I have accomplished my minimal goal. If it is for 100 veterans, I'm real happy! And if I can change the world and everybody becomes aware of it, WOW!!! (And then I look for another cause!) Probably the best situation is I loose round one because you know that is not the end! (If I win I only buy a new house.) If I loose I involve Sen. Bernie's office and just imagine the advertizing I'll get! (Remember, he is the senator that tied up the senate for a whole day with a one man filibuster!) So as I used to say to my victims on the bus, " Sit Down, Shut Up and Hold On, the only thing I can guarantee is it is going to be one hell of a ride! " - 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with Meds. And DASH. . Current BP(last week ave): 131/76 HR 60 Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, and PTSD. Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50 MG. > > > > > > > > > > Ahh, but the PA boxes are still not there to check. To dx PA, > > > > doctors have to think + have attended class that day. > > > > > > > > > > Val > > > > > > > > > > From: hyperaldosteronism [mailto:hyperaldosteronism > > > > ] On Behalf Of Clarence Grim > > > > > > > > > > On the check the box robot dr my guess most would not be here > > > > soars in the process if the boxes had been checked years ago. But > > > > hey we do not want to interfere with a Drs right to do what s/he > > > > wants without being a boxer. > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 8, 2011 Report Share Posted November 8, 2011 A quick scan of these cases makes me think none of these are relevent because they deal with service connected disability. I will be claiming missed DX and inferior care. Besides, the negatives mean absolutely nothing to me unless I have gone all the way to the top and it is the president saying " No " and then I'll ask Pres. Cain for a second opinion! (Can you say Cain-Care? I can't but I can say Bull-Shit!) - 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with Meds. And DASH. . Current BP(last week ave): 131/76 HR 60 Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, and PTSD. Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50 MG. > > > > > > > > > > > > Ahh, but the PA boxes are still not there to check. To dx PA, > > > > > doctors have to think + have attended class that day. > > > > > > > > > > > > Val > > > > > > > > > > > > From: hyperaldosteronism [mailto:hyperaldosteronism > > > > > ] On Behalf Of Clarence Grim > > > > > > > > > > > > On the check the box robot dr my guess most would not be here > > > > > soars in the process if the boxes had been checked years ago. But > > > > > hey we do not want to interfere with a Drs right to do what s/he > > > > > wants without being a boxer. > > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 8, 2011 Report Share Posted November 8, 2011 Then, , they have to think enough to go look in the guidelines. PA check boxes are still not on the check-off list. None of the people you dealt with had read the guidelines? No? Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Bingham They dont have to think. It's in the guidelines. They just have to read. It's actually very simple. Low K, resistant HTN = red flag. But if no low K and still resistant than check still. They just don't. Looking for a pheo is more exciting Ahh, but the PA boxes are still not there to check. To dx PA, doctors have to think + have attended class that day. From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Clarence Grim On the check the box robot dr my guess most would not be here soars in the process if the boxes had been checked years ago. But hey we do not want to interfere with a Drs right to do what s/he wants without being a boxer. . Quote Link to comment Share on other sites More sharing options...
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