Re: 2 hour wait recommendation and AMA

[Guest guest]

The only think I can think is that leaving AMA

is often viewed VERY badly by some medical ppl (eg you

have taken leave of your senses by not following the

doc's recommendations - cuz they are always right!!!!)

I could see your insurance denying you coverage if you

didn't follow the rules as if something does happen

then they will have to foot the bill for the

consequences (eg emerg care etc...)

I work in a hospital. I am surrounded by trained

nurses. There is an ICU down the hall. I asked if I

could inject at work just this once since my xolair

nurse missed my apt due to a miscommmunication. My doc

got the pained expression on his face and asked

" Who would inject it? " Me

" Do I know how to mix it? " Yes and you don't need a

mixer

His reply, " umm no unless there is a xolair clinic

there " I said, um not likely it is a neurological

hospital.

He said flat out no. He mentioned he could ask his

chief but then changed his mind. I gotta come back, 1

week late for my shots.

I have ALL THE STUFF in my fridge. But I am behaving

and not injecting it. So far the wait (I stayed once)

was ok because I was with my mom for her apt then my

apt so it took forever anyway.

Fortunately, I can amble around the hospital so I can

go to the coffee shop and the library. My xolair nurse

said if anything happened the code team was 1 min away

from all areas so it was fine.

Meanwhile, by the time I go to the pharmacy, find

parking (we have 2 hr meter spots or very elusive

spots 3 blocks away), I have consumed an entire

morning off. Fortunately my schedule is flexible so I

just book myself to work evenings that day. There goes

my sleep in!!!

ps Note that Health Canada has said NOTHING yet.....

Ask a question on any topic and get answers from real people. Go to

Answers and share what you know at http://ca.answers.

[Guest guest]

This is getting ridiculous. So far my doc STILL hasn't said

anything. I'm just gonna keep my epi handy and take an antihistamine

and 20mg pred an hour before I " shoot up. " Can't give yourself your

own shots in the middle of a d*@ & hospital. That's ridiculous.

Addy

Group co-owner & very stubborn wench

On Xolair 3+ years

miserable allergic asthmatic 35+ years.

>

> The only think I can think is that leaving AMA

> is often viewed VERY badly by some medical ppl (eg you

> have taken leave of your senses by not following the

> doc's recommendations - cuz they are always right!!!!)

>

> I could see your insurance denying you coverage if you

> didn't follow the rules as if something does happen

> then they will have to foot the bill for the

> consequences (eg emerg care etc...)

>

> I work in a hospital. I am surrounded by trained

> nurses. There is an ICU down the hall. I asked if I

> could inject at work just this once since my xolair

> nurse missed my apt due to a miscommmunication. My doc

> got the pained expression on his face and asked

>

> " Who would inject it? " Me

>

> " Do I know how to mix it? " Yes and you don't need a

> mixer

>

> His reply, " umm no unless there is a xolair clinic

> there " I said, um not likely it is a neurological

> hospital.

>

> He said flat out no. He mentioned he could ask his

> chief but then changed his mind. I gotta come back, 1

> week late for my shots.

>

> I have ALL THE STUFF in my fridge. But I am behaving

> and not injecting it. So far the wait (I stayed once)

> was ok because I was with my mom for her apt then my

> apt so it took forever anyway.

>

> Fortunately, I can amble around the hospital so I can

> go to the coffee shop and the library. My xolair nurse

> said if anything happened the code team was 1 min away

> from all areas so it was fine.

>

> Meanwhile, by the time I go to the pharmacy, find

> parking (we have 2 hr meter spots or very elusive

> spots 3 blocks away), I have consumed an entire

> morning off. Fortunately my schedule is flexible so I

> just book myself to work evenings that day. There goes

> my sleep in!!!

>

>

>

> ps Note that Health Canada has said NOTHING yet.....

>

>

>

> Ask a question on any topic and get answers from real people.

Go to Answers and share what you know at

http://ca.answers.

>

[Guest guest]

Dear Addy: Are you still having to take prednisone? Or is it just the season

right now? I feel so very blessed! I have not had any severe allergies this

season so far, i.e. sneezing, nasal drainage, nasal congestion, cough (although

I have coughed some, but not as in past years.) I can remember in the past

sneezing until I was out of breath; my nose running faster than I could keep up

with it (sorry for the picture, but that's how it was), then the sinus infection

followed by respiratory/lung infection, go on prednisone and antibiotics--I

haven't forgotten being miserable--nose stopped up and lungs, too, making it

very difficult to breathe. So my guess is that the xolair is already helping

after 9 shots.

I do have to sit in the docs office for 30 minutes and I have to show them my

epi pen (that I now carry with me all of the time) before I can leave! But then

I am retired and do have some extra time (sometimes!).

Have a great week all--I do wish all of you easier breathing!

pyle456 <coachmac@...> wrote:

This is getting ridiculous. So far my doc STILL hasn't said

anything. I'm just gonna keep my epi handy and take an antihistamine

and 20mg pred an hour before I " shoot up. " Can't give yourself your

own shots in the middle of a d*@ & hospital. That's ridiculous.

Addy

Group co-owner & very stubborn wench

On Xolair 3+ years

miserable allergic asthmatic 35+ years.

>

> The only think I can think is that leaving AMA

> is often viewed VERY badly by some medical ppl (eg you

> have taken leave of your senses by not following the

> doc's recommendations - cuz they are always right!!!!)

>

> I could see your insurance denying you coverage if you

> didn't follow the rules as if something does happen

> then they will have to foot the bill for the

> consequences (eg emerg care etc...)

>

> I work in a hospital. I am surrounded by trained

> nurses. There is an ICU down the hall. I asked if I

> could inject at work just this once since my xolair

> nurse missed my apt due to a miscommmunication. My doc

> got the pained expression on his face and asked

>

> " Who would inject it? " Me

>

> " Do I know how to mix it? " Yes and you don't need a

> mixer

>

> His reply, " umm no unless there is a xolair clinic

> there " I said, um not likely it is a neurological

> hospital.

>

> He said flat out no. He mentioned he could ask his

> chief but then changed his mind. I gotta come back, 1

> week late for my shots.

>

> I have ALL THE STUFF in my fridge. But I am behaving

> and not injecting it. So far the wait (I stayed once)

> was ok because I was with my mom for her apt then my

> apt so it took forever anyway.

>

> Fortunately, I can amble around the hospital so I can

> go to the coffee shop and the library. My xolair nurse

> said if anything happened the code team was 1 min away

> from all areas so it was fine.

>

> Meanwhile, by the time I go to the pharmacy, find

> parking (we have 2 hr meter spots or very elusive

> spots 3 blocks away), I have consumed an entire

> morning off. Fortunately my schedule is flexible so I

> just book myself to work evenings that day. There goes

> my sleep in!!!

>

>

>

> ps Note that Health Canada has said NOTHING yet.....

>

>

>

> Ask a question on any topic and get answers from real people.

Go to Answers and share what you know at

http://ca.answers.

>

---------------------------------

Ahhh...imagining that irresistible " new car " smell?

Check outnew cars at Autos.

[Guest guest]

Addy, if I were you, I would not bother pre-medicating. You never had a reaction

and there is no evidence that those would prevent one in the first place. Your

body does not need more pred!!

C

(Just my thoughts on the issue....)

Be smarter than spam. See how smart SpamGuard is at giving junk email the

boot with the All-new at http://mrd.mail./try_beta?.intl=ca

[Guest guest]

Careful on the ama. Your insurance weasels could totally not pay for

the office visit etc if the chart gets audited. I worked at a hospital

for 12 years. An ama there usually meant you are paying the whole

bill. I would not be thrilled if that was written on my chart. Ask if

the ama is part of the chart that gets reviewed. Nan

On 4/15/07, heather <heaven1975@...> wrote:

> hi folks,

>

> this 2 hour wait recommendation finally caught up to me. my dr had told me

> about the new FDA recommendation about waiting 2 hours post xolair, but said

> she wasn't making me stay (she knew i wouldn't). this past week, i had to

> sign a form stating that i was aware of the 2 hour wait recommendation.

> they said its not required, but only recommended - but now, to cover their

> butts (which i totally understand) they have to put in my chart " patient

> aware of 2 hour recommendation. left office AMA " ) because i'm leaving right

> after my shots. (i have huge time issues...i have 2 hours to leave work,

> get to the dr, get my shots, run home and feed the dog and get to

> class...and even after class is over, i will not be staying 2 hours). my dr

> is fine with me leaving right away. i do carry an epi-pen (two actually)

> and i'm well versed in anaph. reactions. i'm not concerned, and neither is

> my dr...

>

> i just want to make sure that " AMA " in my chart isn't going to come back

> and bite me in the butt. as in, if my chart for some reason is subpoenaed

> and my insurance co sees " AMA " , that won't be a reason for them to deny the

> xolair, right?? i'm not debating the 2 hour recommendation -- i do'nt want

> to start that up again. i just want to make sure i'm not hurting myself.

>

> oh, and pat --- i mentioned your email about mixing problems to the dr and

> the RN there - they were both shocked. the RN in the office asked me to

> forward it to her email at home since she'd like to read it! they both found

> the idea very interesting (and a little scary!!!) thanks!

>

> thanks to anyone who has some answers!

>

> heather

>

>

> ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

> Check out pics of cape the wonder dog

> (because we always wonder what we'll pull out of his mouth next!)

> http://snipurl.com/z18j (updated 10/06 )

>

>

> If you can find a path with no obstacles, it probably doesn't lead anywhere.

> ~ A.

>

>

>

>

>

>

>

> ---------------------------------

> Ahhh...imagining that irresistible " new car " smell?

> Check outnew cars at Autos.

>

>

[Guest guest]

Boing! You just asked an EXCELLENT question and I'm **also** very

interested in finding out the facts about AMA. About a year ago I

went for a sleep study test - coughed, couldn't breathe right, had to

sit up, the staff hassled me and I bailed out. You would think that

a sleep study center would know about people with lung disorders but

they didn't seem to care. They made me sign a form saying I was

leaving against medical advice but at the same time they didn't even

have ice in the place and the headboard was full of dust which

further triggered my allergic asthma.

So, my point is, if the healthcare provider does not provide proper

accommodations, then don't they bear some responsibility? For that

matter, if you have a reaction outside the doctor's office (say on

the street in front of the doc's office) you certainly would have had

it IN his/her office too. So, the insurance would have to pay for

emergency care either way.

I'm concerned too as there are many times that doctors have made very

BAD decisions and I hardly expect to abide by something that I know

is bad for me such as a prescribed drug to which I am allergic.

Hope to hear more about this!

>

> hi folks,

>

> this 2 hour wait recommendation finally caught up to me. my dr

had told me about the new FDA recommendation about waiting 2 hours

post xolair, but said she wasn't making me stay (she knew i

wouldn't). this past week, i had to sign a form stating that i was

aware of the 2 hour wait recommendation. they said its not required,

but only recommended - but now, to cover their butts (which i totally

understand) they have to put in my chart " patient aware of 2 hour

recommendation. left office AMA " ) because i'm leaving right after my

shots. > i just want to make sure that " AMA " in my chart isn't

going to come back and bite me in the butt. as in, if my chart for

some reason is subpoenaed and my insurance co sees " AMA " , that won't

be a reason for them to deny the xolair, right?? i'm not debating

the 2 hour recommendation -- i do'nt want to start that up again. i

just want to make sure i'm not hurting myself.

>

[Guest guest]

On 4/16/07, instdesgn1 <instdesgn1@...> wrote:

>

>

>

>

>

>

> Boing! You just asked an EXCELLENT question and I'm **also** very >

interested in finding out the facts about AMA. About a year ago I

> went for a sleep study test - coughed, couldn't breathe right, had to

> sit up, the staff hassled me and I bailed out. You would think that

> a sleep study center would know about people with lung disorders but

> they didn't seem to care. They made me sign a form saying I was

> leaving against medical advice but at the same time they didn't even

> have ice in the place and the headboard was full of dust which

> further triggered my allergic asthma.

>

> So, my point is, if the healthcare provider does not provide proper

> accommodations, then don't they bear some responsibility? For that

> matter, if you have a reaction outside the doctor's office (say on

> the street in front of the doc's office) you certainly would have had

> it IN his/her office too. So, the insurance would have to pay for

> emergency care either way.

>

> I'm concerned too as there are many times that doctors have made very

> BAD decisions and I hardly expect to abide by something that I know

> is bad for me such as a prescribed drug to which I am allergic.

>

> Hope to hear more about this!

I talked to my friend who does works in a billing department in a

hospital. The hospital is in the US.

An AMA is a great reason for the insurance company to deny covering

the test/treatment/ etc that you walked out on. Also, it covers the

hospital's and doctors' asses, if you drop dead or have complications

from leaving AMA.

As for your scenario, you leave early from your Xolair injection, and

you have an reaction. It requires ER care. You will get treated in

the ER for the problem. Now the fun begins. If the insurance company

finds out that you left AMA from the doctors office, they could state

that if you had stayed the whole 2 hours, the doctor could have picked

up on the reaction, stopped it, and the reaction wouldn't have morphed

into needed ER care. Bonus round, if you have repeated AMAs (leaving

early), they could refuse to pay for the Xolair and/or the office

visit. They view it as being non compliant with your treament

program.

My friend gets many many angry phone calls from folks, who leave the

detox unit AMA, and find out that they now have a $20K bill. Or the

guy with chest pain that signs AMA from the ER

(after having numerous cardiac tests) and has a $15K bill. It isn't

pretty. Insurance companies don't even want to pay what they should.

With an AMA, they'll basically give you the finger and tell so sad-too

bad. Also, the insurance company usually doesn't give a rat's ass why

you left early either. (per my friend in billing).

Personally, I'd do anything not to get an AMA in my medical records.

I'm not up to doing battle with the insurance company.

Nan-->who's insurance company wishes I'd have a few AMAs so they

wouldn't have to pay.

[Guest guest]

ok, that's a little scary...but this whole 2 hour thing seems silly

since its only suggested ( there's been a lot of things in my life

that were suggested...few actually were worth while. i guess i'll be

asking my dr next week.

(i'm not doubting what you said...just getting frustrated over this

wait/AMA nonsense...just give me my drugs and let me go!)

grrrr

its just to irritating.

thanks for the insight. i swear, my ulcer is growing by the

minute....(add work and school to the mix and man oh man....watch

out!)

heather

--- In , " Little Bee Eater "

>

> I talked to my friend who does works in a billing department in a

> hospital. The hospital is in the US.

>

> An AMA is a great reason for the insurance company to deny covering

> the test/treatment/ etc that you walked out on. Also, it covers

the

> hospital's and doctors' asses, if you drop dead or have

complications

> from leaving AMA.

>

> As for your scenario, you leave early from your Xolair injection,

and

> you have an reaction. It requires ER care. You will get treated

in

> the ER for the problem. Now the fun begins. If the insurance

company

> finds out that you left AMA from the doctors office, they could

state

> that if you had stayed the whole 2 hours, the doctor could have

picked

> up on the reaction, stopped it, and the reaction wouldn't have

morphed

> into needed ER care. Bonus round, if you have repeated AMAs

(leaving

> early), they could refuse to pay for the Xolair and/or the office

> visit. They view it as being non compliant with your treament

> program.

>

> My friend gets many many angry phone calls from folks, who leave

the

> detox unit AMA, and find out that they now have a $20K bill. Or

the

> guy with chest pain that signs AMA from the ER

> (after having numerous cardiac tests) and has a $15K bill. It

isn't

> pretty. Insurance companies don't even want to pay what they

should.

> With an AMA, they'll basically give you the finger and tell so sad-

too

> bad. Also, the insurance company usually doesn't give a rat's ass

why

> you left early either. (per my friend in billing).

>

> Personally, I'd do anything not to get an AMA in my medical

records.

> I'm not up to doing battle with the insurance company.

>

> Nan-->who's insurance company wishes I'd have a few AMAs so they

> wouldn't have to pay.

>