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Foundation Staff.
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| Joined: | Sun Jul 11th, 2004 |
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Posted: Tue Apr 10th, 2007 17:14 |
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Last October we learned that UnitedHealth Care was dropping Quest Labs to contract exclusively with LabCorp for their in-network lab work beginning in 2007.
From a story in today's Wall Street Journal (page B1), we have learned that UnitedHealth Care has been sending letters to doctors in their network, pressuring these doctors to refer all patients to LabCorp or they may either be fined or ousted from their list of network providers if they do not comply.
This tactic has proved controversial, since doctors have some specific tests they prefer from other labs in specific conditions. Some physician groups are speaking out against this move and may prompt investigations. Some physicians say pressure to use LabCorp exclusively is disrupting patient care, both because labs have different tests and "normal ranges" and because labs other than LabCorp dominate some geographic areas.
What all patients with UHC coverage need to know is this: UnitedHealth Care says it has no plans to fine doctors in cases where patients decide on their own to go to an out-of-network lab. So, in case your physician indicates he now must refer you to LabCorp, you still have a choice - but you will have to speak up. You can decide on your own to use Quest or any other lab. Tell your doctor and his staff if you want them to send your blood to a lab other than LabCorp. You may also have to pay more as your share of the cost if services are provided by an out-of-network lab. Check your plan documents, though. You may be responsible for nothing or for as little as 20 percent.
Belinda
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jrfoutin
Research Team
| Joined: | Tue Aug 9th, 2005 |
| Location: | Oregon USA |
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Posted: Fri Apr 13th, 2007 18:29 |
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"The insurer says it has no plans to fine doctors in cases where patients decide on their own to go to an out-of-network lab."
FOR 1,25D TEST, GET THE MOST RELIABLE RESULT
It seems people must be especially vigilant with instructions at the initial 1,25D test if they want the best chance for reliable results on this important first lab test for the MP.
The highest possible reliabily for the 1,25D test is important at the very beginning of the MP and then only annually after that. 1,25D does not need to be tested as frequently as the less-fussy and less-expensive 25D test (Labcorp or other labs generally produce reliable results for this one).
WHAT TO TELL YOUR DOCTOR:
It appears the doctor just has to write the words "per patient request" to bypass negative repercussions for his office to specify Quest. The patient must inform their doctor to drive the Quest lab order.
When "per patient request" appears on the lab order, then the MPer and their insurance company must iron out financial coverage details, which could only be the difference, not the full cost of the test. Do check that, however.
Calling the insurance carrier may be helpful from a financial perspective, but as reliability on the initial 1,25D test is the purpose for having the test in the first place, that should be the determining factor for choosing Quest.
In summary, and where possible to improve one's chances for the most reliable 1,25D test, people can:
1. Insist on "per patient request" written on the Drs order/insurance detail specifying Quest Diagnostics.
2. Be prepared to review handling details with the drawing tech to assure the process matches Quest's requirement for a properly drawn, centrifuged and frozen sample shipped for this very sensitive metabolite.
3. Discuss "difference" payment with their insurer.
____________________
Sarcoidosis 125D61, MP10/05 ModP2 12/05 Ph2 6/06 Ph3 10/06, NoIRs limited outings covered, 2/08 25D6.2, 10/08 25D6.9
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Dr Trevor Marshall
Research Team
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Posted: Wed Aug 8th, 2007 04:21 |
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jalexe414 wrote:
My hospital has a contract with LabCorp to provide its laboratory
services, unless they do not provide them. Therefore, I had the lab director
contact LabCorp about the proper handling of 25 and 1,25 specimens. We
felt like we were acknowledged and got cooperation and I am thinking
my results look reliablle. Granted theri norms are not Merck,s, but I
run my data thru the MP staff anyway for interpretation and can make my
own judgement using the Merck normals.
I am sure that LabCorp doesn't want the fussing. Has anyone from MP
called them to discuss your concerns regarding normal values and specimen
handling?
Eric, jalexe414
Eric,
I goofed. You had a double post here and I accidentally deleted them both. Sorry about that. The web server has been acting up today  Anyway, yes, Labcorp has been contacted on several occasions and given a copy of Quest's handling instructions, which we regard as setting the standard. The primary requirement is that the sample be rejected if it arrives at the assay point not frozen. The moderators can point you to the Quest letter, or maybe we can reproduce it here again, as it has been lost in the depths of the FAQs, I think.
Click here for a copy of the handling procedures from Quest's website.
Additionally, the hospital with whom we are planning the Phase 3 study uses Labcorp, and the Labcorp lab manager there on site has assured us that all the samples will be processed exactly as per the Quest procedures during the study.
I guess eventually Labcorp Corporate will hear the rumbling from the grass roots.
..Trevor..
ps: sorry again about accidentally deleting both copies of your post
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