Re: Vitamin D again and insurance again, sorry

[Guest guest]

Hollie and group,

after re reading your post, I believe I understand what may have happened here.

Oncology offices frequently have on premises labs to do their usual blood work.

They are probably not set up to do a vitamin D level test and most likely sent

your blood out to an 'outside' lab. It may be that the lab they use or chose is

not in your network. OR it could be that that lab has not sent you the bill

yet... By contrast, most general medicine doctors do not have labs in house

and almost always send specimens out for evaluation. These doctors may have

several options and it is up to the patient to ask what lab they use, and check

to see if your insurance covers that lab. In some cases you may be able to go

outside of network for some tests.

In cases such as this you can try to ask the office where the test was done to

submit to your insurance company, however they may not be set up to do that, or

be unwilling to do so. In this case you may have to contact your insurance

company and submit the bill yourself. Once you do work out this system it's

easier to keep track of.

The one glitch here is that some CLL doctors may have labs in their own suite,

but if they are part of a large research hospital, which most are, they will

also have labs in house that do all manner of tests. IF his hospital is in

your network, chances are his labs will be, but not necessarily since some 'in

house' facilities are leased out to other companies but are physically in the

hospital, same is true of radiology depts. it is not uncommon to get separate

bills for laboratory tests for any doctor. There may be one charge for 'blood

draw'/phlebotomy, and another for the actual test.

It is important that patients know, to the best of their ability, what labs are

being used, and if necessary fight to have your specimens sent to a the same lab

as much as possible. For CBC and Electrolytes try to use the same lab each time

as different labs may have different ranges and this can be confusing. (your

insurance company may 'specify a preferred lab' but this does not mean they

won't pay if you choose to use a different one.

Know your labs, know your tests, get the printed copies, unless they are

available on line, some are now, and keep your test results. I highly

recommend that new CLL patients begin charting their blood work. As one who did

not begin the beguine, I was very sorry. I see the value of keeping all test

results charted so that any rises and falls can be seen for what they are,

usually small glitches... trends are more easily spotted earlier in this way and

can be acted on sooner. Do not expect your various doctors to do this for you.

Some will have your blood work charted, IF they have access to all of your tests

in house, others will not. The charts that are on www.clltopics.org are very

good since if one mouses over each 'test' name a box comes up to explain to you

what that test MAY be revealing. These charts use xcel. hence you can add

columns to suite your needs such as thyroid and D or whatever other tests you

have performed on a regular basis.

all my best, beth fillman

[Guest guest]

To Hollie and group,

Most of the time your doctor can write an order to have the

lab work done at a hospital outpatient lab. My Onc did that

for me to have a creatinine level drawn since his lab didn't

do that test. I had to have that done before my ct scan

since the rule was to make sure my kidneys work before I got

the dye for the scan since I was over 60. So I am sure your

doc can do that also.

Jan