| Author |
Getting prescription for Enbrel approved by insurance
|
|
| fkissam 2005-05-06, 8:47 am |
| The insurance company will cover Enbrel if the doctor sends the required lab
work and documentation.
What lab work have people sent that has worked successfully? If the MRI
and Xrays throughout the body show arthritis, is that usually enough?
ANY HELP WOULD BE APPRECIATED FOR THIS EXPENSIVE DRUG.
Thank you.
| |
| Harvey R. Stone 2005-05-06, 8:47 am |
|
"fkissam" <fkissam@bellsouth.net> wrote in message
news:YpPde.124763$f%4.95280@bignews1.bellsouth.net...
> The insurance company will cover Enbrel if the doctor sends the required
> lab
> work and documentation.
>
> What lab work have people sent that has worked successfully? If the MRI
> and Xrays throughout the body show arthritis, is that usually enough?
>
> ANY HELP WOULD BE APPRECIATED FOR THIS EXPENSIVE DRUG.
>
> Thank you.
>
>
Usually,,, the insurance company needs to know that you have tried and
failed with the cheaper drugs or DMARDs. Its all about money. As far as
I know, the most expensive is Remicade because of the need for RNs to give
it to you.
The cheaper drugs are Methx and Arava and maybe a couple more that I
have not taken.
The truth of it is that your immune system must be controlled and the
insurance need to do that so that they do not have to pay for $40, 000 joint
replacements but in my world its about my arteries and veins and organs that
inflam.arth can ruin.
harv
| |
| Jeff and Mary 2005-05-06, 8:47 am |
| the expense of remicade is the drug, the mark up, not the nurses. i know
from the breakdown of the bill. the costs from the hosptial itself is
minimal as compared to the drug cost.
jeffy
"Harvey R. Stone" <none@nobody.net> wrote in message
news:3oRde.2014$Vz4.1012@newssvr11.news.prodigy.com...
>
> "fkissam" <fkissam@bellsouth.net> wrote in message
> news:YpPde.124763$f%4.95280@bignews1.bellsouth.net...
MRI[vbcol=seagreen]
> Usually,,, the insurance company needs to know that you have tried and
> failed with the cheaper drugs or DMARDs. Its all about money. As far
as
> I know, the most expensive is Remicade because of the need for RNs to give
> it to you.
> The cheaper drugs are Methx and Arava and maybe a couple more that I
> have not taken.
> The truth of it is that your immune system must be controlled and the
> insurance need to do that so that they do not have to pay for $40, 000
joint
> replacements but in my world its about my arteries and veins and organs
that
> inflam.arth can ruin.
> harv
>
>
| |
| Harvey R. Stone 2005-05-06, 11:46 am |
|
"Jeff and Mary" <the5berks@advnet.net> wrote in message
news:18669$4278468d$4527465c$23069@123.NET...
> the expense of remicade is the drug, the mark up, not the nurses. i know
> from the breakdown of the bill. the costs from the hosptial itself is
> minimal as compared to the drug cost.
> jeffy
>
On my bill, it was $285 per hour for two hours.... in my world that is a
great deal of money. I know the cost of the Remicade itself is high but
Soc.Sec is involved which probably pushed the cost up. In some peoples
world the cost of having the gov. involved is free and they need to look a
little clooooser. IMO
Harv
| |
| firechief 2005-05-06, 5:46 pm |
| Harv wrote:
> I know, the most expensive is Remicade because of the need
> for RNs to give it to you.
Humira and other newer drugs are more expensive.
When an RN has 4, 5, 6 people in chairs receiving Remicade
(or another drug), the per-person expense is much less. If
the doctor's office is conducting drug trials (like mine is) the
drug manufacturer pays for the RN's time.
.... AGENT 007's tombstone: His Number Was Up.
| |
| Harvey R. Stone 2005-05-06, 5:46 pm |
|
"firechief" <firechief@jjfpd.gov> wrote in message
news:Lzbee.15670$_K.11268@fed1read03...
> Harv wrote:
>
>
> Humira and other newer drugs are more expensive.
>
> When an RN has 4, 5, 6 people in chairs receiving Remicade
> (or another drug), the per-person expense is much less. If
> the doctor's office is conducting drug trials (like mine is) the
> drug manufacturer pays for the RN's time.
>
Hi Chief, I think there are 5 chairs in the main room and another room
with 3. The listed charges were the same no matter if I was my myself or
both rooms going. I am sorry to read that Humira cost more.
I am now back on Enbrel because of the reaction to Remicde and in 3-4
years when my insurance runs out,, I have no idea what will take place. I
may invest in a wheelchair if the good Lord gives me that much time.
Harv
| |
| firechief 2005-05-06, 5:46 pm |
| Harv wrote:
> Hi Chief, I think there are 5 chairs in the main room and another
> room with 3. The listed charges were the same no matter if I was
> my myself or both rooms going.
That's what I've been suspecting. Medicare and insurance
companies are being double/tripled billed for the same
procedure.
> I am sorry to read that Humira cost more.
That's why I was denied it and put on Remicade.
.... !llaW ehT ffO ,rorriM ,rorriM
| |
| Jeff and Mary 2005-05-06, 10:45 pm |
| how would you like my $7,000 bill to ponder over?
jeffy
"Harvey R. Stone" <none@nobody.net> wrote in message
news:rC3ee.735$1o3.543@newssvr12.news.prodigy.com...
>
> "Jeff and Mary" <the5berks@advnet.net> wrote in message
> news:18669$4278468d$4527465c$23069@123.NET...
know[vbcol=seagreen]
>
> On my bill, it was $285 per hour for two hours.... in my world that is a
> great deal of money. I know the cost of the Remicade itself is high but
> Soc.Sec is involved which probably pushed the cost up. In some peoples
> world the cost of having the gov. involved is free and they need to look a
> little clooooser. IMO
> Harv
>
>
| |
| Jeff and Mary 2005-05-06, 10:45 pm |
| true, however the charge for infusion is the same whether or not there are
10 people or 1 person present at the time. .... it's called "overhead".
jeffy
"firechief" <firechief@jjfpd.gov> wrote in message
news:Lzbee.15670$_K.11268@fed1read03...
> Harv wrote:
>
>
> Humira and other newer drugs are more expensive.
>
> When an RN has 4, 5, 6 people in chairs receiving Remicade
> (or another drug), the per-person expense is much less. If
> the doctor's office is conducting drug trials (like mine is) the
> drug manufacturer pays for the RN's time.
>
>
> ... AGENT 007's tombstone: His Number Was Up.
>
>
| |
| Jeff and Mary 2005-05-06, 10:45 pm |
| he sould be reported to your insurance company. they can't charge for
"office calls" and never see you. it is called "fraud".
jeffy
"Jo Firey" <JAfirey@NETZERO.NET> wrote in message
news:3dtloqF4qrkU2@individual.net...
>
> "firechief" <firechief@jjfpd.gov> wrote in message
> news:dNgee.15760$_K.8712@fed1read03...
> I got into a huge fight with the "doctor" who was overseeing my last round
> of allergy shots. There had to be an MD present for the shots to be
> administered. So they were billing for an MD office visit for each shot.
> But there were usually about 20 of us there at a time waiting for our ten
> minutes to make sure there was no reaction. And I don't think I ever even
> met the doctor in charge.
>
>
>
| |
| Nann Bell 2005-05-07, 11:45 am |
| >> I got into a huge fight with the "doctor" who was overseeing my last round[vbcol=seagreen]
Whoa! I've had allergy shots at three different offices, thanks to moves,
and never had anyone try to pull that crap. Today, I suspect the insurance
companies wouldn't let him get away with it.
--
Nann
remove the Gator cheer to email me
Simply the thing I am shall make me live --- William Shakespeare
| |
| Jo Firey 2005-05-07, 5:46 pm |
|
"Nann Bell" <hanbellGOGATORS@earthlink.net> wrote in message
news:0001HW.BEA2543F0042C07D12874430@news.east.earthlink.net...
>
> Whoa! I've had allergy shots at three different offices, thanks to moves,
> and never had anyone try to pull that crap. Today, I suspect the
> insurance
> companies wouldn't let him get away with it.
>
>
Mine wouldn't pay it then. He thought I would!
Jo
| |
| Nann Bell 2005-05-10, 11:50 am |
| >> I got into a huge fight with the "doctor" who was overseeing my last round[vbcol=seagreen]
Whoa! I've had allergy shots at three different offices, thanks to moves,
and never had anyone try to pull that crap. Today, I suspect the insurance
companies wouldn't let him get away with it.
--
Nann
remove the Gator cheer to email me
Simply the thing I am shall make me live --- William Shakespeare
| |
| Harvey R. Stone 2005-05-10, 11:50 am |
|
"firechief" <firechief@jjfpd.gov> wrote in message
news:Lzbee.15670$_K.11268@fed1read03...
> Harv wrote:
>
>
> Humira and other newer drugs are more expensive.
>
> When an RN has 4, 5, 6 people in chairs receiving Remicade
> (or another drug), the per-person expense is much less. If
> the doctor's office is conducting drug trials (like mine is) the
> drug manufacturer pays for the RN's time.
>
Hi Chief, I think there are 5 chairs in the main room and another room
with 3. The listed charges were the same no matter if I was my myself or
both rooms going. I am sorry to read that Humira cost more.
I am now back on Enbrel because of the reaction to Remicde and in 3-4
years when my insurance runs out,, I have no idea what will take place. I
may invest in a wheelchair if the good Lord gives me that much time.
Harv
| |
| firechief 2005-05-10, 11:50 am |
| Harv wrote:
> I know, the most expensive is Remicade because of the need
> for RNs to give it to you.
Humira and other newer drugs are more expensive.
When an RN has 4, 5, 6 people in chairs receiving Remicade
(or another drug), the per-person expense is much less. If
the doctor's office is conducting drug trials (like mine is) the
drug manufacturer pays for the RN's time.
.... AGENT 007's tombstone: His Number Was Up.
| |
| Jeff and Mary 2005-05-12, 11:53 am |
| how would you like my $7,000 bill to ponder over?
jeffy
"Harvey R. Stone" <none@nobody.net> wrote in message
news:rC3ee.735$1o3.543@newssvr12.news.prodigy.com...
>
> "Jeff and Mary" <the5berks@advnet.net> wrote in message
> news:18669$4278468d$4527465c$23069@123.NET...
know[vbcol=seagreen]
>
> On my bill, it was $285 per hour for two hours.... in my world that is a
> great deal of money. I know the cost of the Remicade itself is high but
> Soc.Sec is involved which probably pushed the cost up. In some peoples
> world the cost of having the gov. involved is free and they need to look a
> little clooooser. IMO
> Harv
>
>
| |
| Jeff and Mary 2005-05-12, 11:53 am |
| he sould be reported to your insurance company. they can't charge for
"office calls" and never see you. it is called "fraud".
jeffy
"Jo Firey" <JAfirey@NETZERO.NET> wrote in message
news:3dtloqF4qrkU2@individual.net...
>
> "firechief" <firechief@jjfpd.gov> wrote in message
> news:dNgee.15760$_K.8712@fed1read03...
> I got into a huge fight with the "doctor" who was overseeing my last round
> of allergy shots. There had to be an MD present for the shots to be
> administered. So they were billing for an MD office visit for each shot.
> But there were usually about 20 of us there at a time waiting for our ten
> minutes to make sure there was no reaction. And I don't think I ever even
> met the doctor in charge.
>
>
>
| |
| Jeff and Mary 2005-05-12, 11:53 am |
| true, however the charge for infusion is the same whether or not there are
10 people or 1 person present at the time. .... it's called "overhead".
jeffy
"firechief" <firechief@jjfpd.gov> wrote in message
news:Lzbee.15670$_K.11268@fed1read03...
> Harv wrote:
>
>
> Humira and other newer drugs are more expensive.
>
> When an RN has 4, 5, 6 people in chairs receiving Remicade
> (or another drug), the per-person expense is much less. If
> the doctor's office is conducting drug trials (like mine is) the
> drug manufacturer pays for the RN's time.
>
>
> ... AGENT 007's tombstone: His Number Was Up.
>
>
| |
| Jo Firey 2005-05-12, 11:53 am |
|
"Nann Bell" <hanbellGOGATORS@earthlink.net> wrote in message
news:0001HW.BEA2543F0042C07D12874430@news.east.earthlink.net...
>
> Whoa! I've had allergy shots at three different offices, thanks to moves,
> and never had anyone try to pull that crap. Today, I suspect the
> insurance
> companies wouldn't let him get away with it.
>
>
Mine wouldn't pay it then. He thought I would!
Jo
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