My lyme doc who is out of kaiser's wants to start me on IV rocephin but I need to get it covered by kaiser insurance.
I tested postive for lyme according to igenex, but I can't find a doctor who feels comfortable enough to put in a picc line. My regular kaiser doc has agreed to give me the rocephin, but I still need the picc put in as well as someone to come clean it and all that good stuff.
Please let me know if you know of any kaiser doctors who are willing to put a picc line in for lyme.
Thanks Lindsay
Posts: 484 | From Burlingame, Ca | Registered: Sep 2005
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posted
My kids' LLMD wrote a script for IV Primaxin. The script was sent to an in-network home health agency. The agency contracted a company (PICC Stat) to come to our home to put the PICC line it.
The home health nurse comes once a week to change the dressing and draws blood. The HH agency sends the supplies to us once a week.
Because the HH agency is in-network, we haven't paid anything so far for their IVs.
Can you contact your insurance company for names of in-network HH agencies?
-------------------- Peggy
~ ~ Hope is a powerful medicine. ~ ~ Posts: 2775 | From MN | Registered: Apr 2001
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I am well aware that Kaiser is unaware of how to treat lyme correctly. I am seeing a great doc in los altos who is putting me on the right track but unforchunetly, I can't afford to do this treatment without my insurances help.
I am very confident in my LLMD but I know there must be a way to get kaiser to pay for the picc. My primary care physician is willing to give me rocephin but she isn't comfortable with giving me treatment with the picc line and all that.
I know there must be a way to make them pay for my treatment and I just need to figure out how I can do it-
Thanks, Lindsay
Posts: 484 | From Burlingame, Ca | Registered: Sep 2005
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Michelle M
Frequent Contributor (1K+ posts)
Member # 7200
posted
Hi Smiles!
So glad you're getting a PICC. Good for you.
You don't really find a doc - the home health care lines ALL that up for you. You contact the home health care place, tell them that you have a scrip from your Kaiser doc, then THEY set you up with an appointment to put in the line at wherever it's done. A doc THERE will check out the placement (xray it, etc), okay it, and you're all set. They will show you how it works, then arrange to come to your house, or you stop in at THEIR business.
The company that took care of my PICC stuff was called "Option Care." They placed the line, had the doc review the xray film, gave me a little lesson, sent me on my way. Then I went by there once a week on my lunch hour and got the dressing change. They also contacted my insurance company and did all the paperwork for me.
Call your insurance company as suggested above or get in the yellow pages and call a home health care or 'home infusion' company.
Good luck!
Michelle
Posts: 3193 | From Northern California | Registered: Apr 2005
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posted
Thanks for your opionin but the problem is that the kaiser docs don't want to put a picc line in. That's the problem. My LLMD is out of network and Kaiser insurance is very different-I have NO out of network coverage. I am not sure that I could just call a home health care company and have it be covered by my insurance. I can't get any of this without my insurances help.
My LLMD could write the script but it has to be covered.
-Lindsay
Posts: 484 | From Burlingame, Ca | Registered: Sep 2005
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trails
Frequent Contributor (1K+ posts)
Member # 1620
posted
Smiles,
If your "regular doc" is willing to give you the rocephin, but not willing to ORDER the PICC, I think you might be out of luck. If your "regular doc" is your PCP In-network, Kaiser doc and they will not write the order/script, then I do not think Kaiser will pay for the PICC.
But what really does NOT make sense is why your PCP (regular doc) is willing to "give you rocephin" and NOT willing to write a script to insert the line?
Wait...it says he/she IS willing to write the script.
If the Kaiser Doc ORDERS the PICC, then there should be a KAISER facility to insert it. They do NOT have to agree about the treatment, they just have to follow that doc's orders.
A PCP is NEVER the person to insert a PICC line. That is done by a nurse and usually at a hospital so they can x-ray and monitor your first infusion.
Your PCP should be handling the PAPERWORK around the PICC, not the ACTUAL PICC.
This is my experience with an HMO while in NM.
is it making sense?
Hoe it helps, trails
Posts: 1950 | From New Mexico | Registered: Sep 2001
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posted
My kids' LLMD is out-of-network. He wrote the script for PICC placement and IV Primaxin. He faxed the script to an in-network home health agency.
Our insurance pays 100% of the in-network for IVs. It doesn't matter who wrote the script.
It works the same way as other meds. Our LLMD writes the script and we bring them to our local pharmacy and they are covered. Our insurance doesn't care who writes the script but they care where the service/meds are provided.
-------------------- Peggy
~ ~ Hope is a powerful medicine. ~ ~ Posts: 2775 | From MN | Registered: Apr 2001
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posted
my doc orginally agreed to give me rocephin but now she is being closely watched by internal medicine who doesn't believe I have lyme-even though i tested positive according to igenex.
she said if i can find one other kaiser doctor to back her on this she would give me the iv and picc line.
I was just hoping that maybe one of you had kaiser and could possibly help me with a name of someone who was open to picc lines.
I know that kaiser is one of the biggest offenders but I have no choice-I need IV treatment and I know where there is a will there is a way-
thanks for the advice please feel free to keep writting-I need the support!
Posts: 484 | From Burlingame, Ca | Registered: Sep 2005
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How's it going? I saw the word "Kaiser" in the title and knew it would be you posting . . .
Have you tried Rife? It's workerd well for me, and I'll probably be investing soon . . .
Good luck!
Posts: 45 | From Pittsburgh, PA | Registered: Nov 2005
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trails
Frequent Contributor (1K+ posts)
Member # 1620
posted
I am really sorry to hear all of this and I really sympathise with your frustration. I had IV Rocephin in 2001 and it helped tremendously. (3 years NO sx!)
2 different LLMD's would like for me to be on it NOW, but alas, Blue Cross CA only pays 1 month, and BOTH LLMDs (and lotsa people here) said they have NEVER been able to bust through that barrier.
(If anyone reading this disagrees...please PM ME!)
I need more than a month, and we (my "treatment team")all agree that one month might actually hurt more than help.
(BTW-I test positive even through local labs and have had spinal fluid test positive too-not that that matters to those of us who UNDERSTAND this disease, but that it does matter to insurance)
I KNOW that IV ABX would be the quickest route to health, but it is not possible.
But there ARE other routes. MANY of us have been denied IV ABX and many have made great progress with orals.
It sounds like your Kaiser doc is not very sincere, no matter HOW much you may think they are trying to be open minded. It is NOT good medical practice to say, well, if you can find someone ELSE to do it, then I am in. That sounds more like 7th grade.
I know that they said they are "being watched," but to me, that is a way to weasle out of responsibility.
I am sorry that comes off rude, I dont mean to be to you, I am just angry that someone who holds so much power over your health and well being would play these kinds of tricks.
I have not heard of a Kaiser doc that treats Lyme appropriately. I researched a lot before moving to CA this year b/c I needed better care.
BUT--maybe someone DOES know a Kaiser doc who treats Lyme?????
Best of luck to you! Trails
Posts: 1950 | From New Mexico | Registered: Sep 2001
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posted
Thanks for all your messages. I really need to find a doctor that can help me. I think my kaiser doc that was helping me is going to be screwed by the politics of kaiser and might face losing her job.
I really need to figure out how to get an IV-any suggestions??
-Lindsay
Posts: 484 | From Burlingame, Ca | Registered: Sep 2005
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just don
Frequent Contributor (1K+ posts)
Member # 1129
posted
Sounds like, get a script for IV and another for Pic line from"LLMD" and forget the Kaiser people. Call the pharmacy or home health co. and have them do it. Can you afford not to 'just do it'??? Turn in the bills to kaiser and let the chips fall where they may. Your health isnt to be nickeled and dimed with. Either that or stay on orals. My insurance wouldnt pay for anything but temp short term IV's after they approved the central line with no probs. So I had exact opposite problem. They would gladly do the line but then THAT put me into 'managed care' and to say that made it tough would be a slight. Nice lady to talk me into going into it. Once there a nightmare in waiting. It is all about limiting insurance outlay, PERIOD!! They say it is for YOUR best care, phooey altho other unprintable words come to mind. Makes me too mad to even think about it so I dont!!! How hard would it be to change insurance co.?? Doesnt sound like these kaiser folks are going to help you any way you look at it. They sound like they will give you couple three weeks and pull the plug anyway. So hows that help you???!!!I dont know because I am --just don--
-------------------- just don Posts: 4548 | From Middle of midwest | Registered: May 2001
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