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Doctor and Insurance Experience Plus Lab Results
I've been so depressed lately that it is becoming overwhelming. My weight gain is out of control even after starting to exercise about 7 weeks ago. I have no energy AT ALL and just getting through the day is a difficult task.
But a coworker of my husband's recommended a doctor and I thought I would give her a shot. I couldn't get in with the doctor I wanted (Dr. Kate Lemmerman) but the doctor I did get in with said that Dr. Lemmerman would be looking at my chart, etc.
Before I made my appointment I found out that an initial consultation would be $285 that my insurance would not cover. I found out who they did their bloodwork through and found out after speaking with the insurance company that that part would be covered. So, I said I would suck up the $285 because if they could help me it would be worth it.
I went to my first visit (and only visit). I was really pleased with the office, the help, and that it seemed like the doctor actually took an interest. She took me off Levothyroxine and put me on an equal amount of Armour. I was happy that she changed my prescription right away. After she got back my current labs she is also prescribing Cytomel (found that out today).
But - I cannot afford to go back to the doctor. I checked the claim with my insurance money and they denied ALL the charges - $706 worth. I was so upset I couldn't even function. I sent a fax to the doctor's office and said that my insurance denied everything because they billed everything under themselves. I asked if they could bill the lab charges under Fairfax Medical Laboratories who my insurance covers. They, to this point have refused. They apparently tack on a hefty amount of profit so that's why they bill it under their name. They said that they could set me up with a payment plan over 6 months but the point is that I can't afford to go back. They want me back in one month to check my bloodwork again...that visit would be $250 (office visit) plus all of the blood work....$400 worth again???
I'm devasted. I finally found a set of doctors who seem to be listening but there is no way I can afford to pay their fees. And I'm pretty mad that they won't bill the bloodwork properly when my insurance would cover it. They won't budge. I don't know what I'm going to do. I have a one month supply of Armour and I'm not sure if the Cytomel has been called in yet or not. What do I do???? I feel like I'm back to square one and I feel like I've been somehow been used for profit. I really don't know what to do.
My labs were not horrible, they are much better than the last time but they said my TSH can definitely go down some:
T3, Free 2.91 (2.30 - 4.20)
T4, Free 1.0 (0.6 - 1.8)
TSH 3rd Generation 3.772 (0.350 - 5.500)
I don't have what my reverse T3 is yet because supposedly they took that too.
I am on 90mg of Armour and they want me on 5mcg of Cytomel. If it works - it's almost too bad because I can't find a doctor who will prescribe any different than Synthroid/Levothyroxine.
But a coworker of my husband's recommended a doctor and I thought I would give her a shot. I couldn't get in with the doctor I wanted (Dr. Kate Lemmerman) but the doctor I did get in with said that Dr. Lemmerman would be looking at my chart, etc.
Before I made my appointment I found out that an initial consultation would be $285 that my insurance would not cover. I found out who they did their bloodwork through and found out after speaking with the insurance company that that part would be covered. So, I said I would suck up the $285 because if they could help me it would be worth it.
I went to my first visit (and only visit). I was really pleased with the office, the help, and that it seemed like the doctor actually took an interest. She took me off Levothyroxine and put me on an equal amount of Armour. I was happy that she changed my prescription right away. After she got back my current labs she is also prescribing Cytomel (found that out today).
But - I cannot afford to go back to the doctor. I checked the claim with my insurance money and they denied ALL the charges - $706 worth. I was so upset I couldn't even function. I sent a fax to the doctor's office and said that my insurance denied everything because they billed everything under themselves. I asked if they could bill the lab charges under Fairfax Medical Laboratories who my insurance covers. They, to this point have refused. They apparently tack on a hefty amount of profit so that's why they bill it under their name. They said that they could set me up with a payment plan over 6 months but the point is that I can't afford to go back. They want me back in one month to check my bloodwork again...that visit would be $250 (office visit) plus all of the blood work....$400 worth again???
I'm devasted. I finally found a set of doctors who seem to be listening but there is no way I can afford to pay their fees. And I'm pretty mad that they won't bill the bloodwork properly when my insurance would cover it. They won't budge. I don't know what I'm going to do. I have a one month supply of Armour and I'm not sure if the Cytomel has been called in yet or not. What do I do???? I feel like I'm back to square one and I feel like I've been somehow been used for profit. I really don't know what to do.
My labs were not horrible, they are much better than the last time but they said my TSH can definitely go down some:
T3, Free 2.91 (2.30 - 4.20)
T4, Free 1.0 (0.6 - 1.8)
TSH 3rd Generation 3.772 (0.350 - 5.500)
I don't have what my reverse T3 is yet because supposedly they took that too.
I am on 90mg of Armour and they want me on 5mcg of Cytomel. If it works - it's almost too bad because I can't find a doctor who will prescribe any different than Synthroid/Levothyroxine.
OMG! I just happened to trip upon this discussion page and I swear you are me! I was diagnosed with Hashimotos about 4 years ago, after being on meds for hypo for years. My dr couldnt keep me regulated, they kept saying it was due to pregnancies and nursing, I've had 3 kids. That explanation worked until after my youngest was born and I had stopped nursing. I never have been good at taking my medicine, simply because i don't like the way it makes me feel. When i take my meds I have terrible mood swings and get depressed! Sound familiar? I have been told that it was just my imagination I begin to feel like I am choking again and its hard to swallow, I start taking my meds again.
I am a believer that one intervention leads to another, which leads to another. I don't want or need anti depressants! And I'm not crazy either, just ask my family, my husband can always tell when I start taking my thyroid meds, i'm not very nice anymore, and that *****!
So after complaining to my gp and flat out refusing to take synthroid or levoxyl, I was prescribed armour thyroid instead. It is much better than the others were, but my gp only pretends to know what hashimotos is. Of course he's heard of it, when I took anatomy in college in was in the text book, but that is much different than "knowing" about it.
I find it very difficult to lose weight and even while exercising and watching what I eat I am still gaining. Yes I am currently taking my thyroid meds and have a very low dose on xanex that I take about one or two days a month when I am being very mean, usually on PMS days. That is another problem that I have had is a much heavier and longer flow.
Now you know half of my life story! I have went from dr's saying I am hypo to another doing the test where you swallow the radioactive agent and that dr saying that he didn't know why I have ever taken thyroid meds, to my levels being around 20ish and being put back on meds to being told I am fine and don't need the meds again and the next time I was tested after being off of the meds for about 6-8 months my levels didn't even register on the chart they were 104, with under 5 being normal. That is when i saw the endocrinologist in Oklahoma (who also by the way charged me a ridiculous amount of $$ that my insurance wouldn't cover either, I went 1 time).
I don't know, I know I ramble, but I just want you to know that you are not alone! I pray that you find a solution that will work for you. For now I am taking my meds and treating the side effects, I decided that was better than they symptoms of hashimotos hypo thyroidism!
Good Luck
I am a believer that one intervention leads to another, which leads to another. I don't want or need anti depressants! And I'm not crazy either, just ask my family, my husband can always tell when I start taking my thyroid meds, i'm not very nice anymore, and that *****!
So after complaining to my gp and flat out refusing to take synthroid or levoxyl, I was prescribed armour thyroid instead. It is much better than the others were, but my gp only pretends to know what hashimotos is. Of course he's heard of it, when I took anatomy in college in was in the text book, but that is much different than "knowing" about it.
I find it very difficult to lose weight and even while exercising and watching what I eat I am still gaining. Yes I am currently taking my thyroid meds and have a very low dose on xanex that I take about one or two days a month when I am being very mean, usually on PMS days. That is another problem that I have had is a much heavier and longer flow.
Now you know half of my life story! I have went from dr's saying I am hypo to another doing the test where you swallow the radioactive agent and that dr saying that he didn't know why I have ever taken thyroid meds, to my levels being around 20ish and being put back on meds to being told I am fine and don't need the meds again and the next time I was tested after being off of the meds for about 6-8 months my levels didn't even register on the chart they were 104, with under 5 being normal. That is when i saw the endocrinologist in Oklahoma (who also by the way charged me a ridiculous amount of $$ that my insurance wouldn't cover either, I went 1 time).
I don't know, I know I ramble, but I just want you to know that you are not alone! I pray that you find a solution that will work for you. For now I am taking my meds and treating the side effects, I decided that was better than they symptoms of hashimotos hypo thyroidism!
Good Luck
I have basically been dealing with the same type of situation, with the exception for the out of network doctor is not stilling me blind. Even though I like this doctor, I can't afford to keep going back. (By the way, after the intial visit it was just $120 and he has dropped to $94. since I was self pay). There are other doctors, maybe a pharmacy could advise you what doctors fill armour? Anyway, I was able to get my primary care doctor to order the labs for me since I had been in there over and over requesting someone help me. AFter going to see my primary and getting him to agree, I gave him the lab slip and he re-wrote for me to get covered. So that may be an option for you. I am now changing primary care doctors even though he was willing to do that in hopes that I can get this new one to start working with me since I am now ON armour. Big decision considering that the other one was willing to do that, but I need a doctor who will get me better and juggling between doctors wasn't it.
It is odd to me that they want to add Cytomel to Armour, that seems odd to add more t3 rather than just raising Armour - but I am not a dosaging expert. Still working out my own nightmare but we just added synthroid to my armour to get more steady dosage. I really would suggest you seek out another doctor some way some how. Waiting until Nov is a long time away. I have been so depressed and mad also, but finally realized that wasn't helping my situation and in fact, as many will tell you, Stress is horrible on thyroid. So, I am trying to go back to acceptance of this unfair affliction and just determination that I will find someone somehow to help. I have been battling for years and its hard to keep up the fight, but we must carry on as I know in my heart we can get better. Hang in there! Send that doctor $5.00 a month while you seek out real help!
Take a Deep Breath and start asking everyone and anyone about someone they might know that is reputable and semi affordable. Also might talk to health food stores, so here in my area have really knowledgeable people. Good luck!!
It is odd to me that they want to add Cytomel to Armour, that seems odd to add more t3 rather than just raising Armour - but I am not a dosaging expert. Still working out my own nightmare but we just added synthroid to my armour to get more steady dosage. I really would suggest you seek out another doctor some way some how. Waiting until Nov is a long time away. I have been so depressed and mad also, but finally realized that wasn't helping my situation and in fact, as many will tell you, Stress is horrible on thyroid. So, I am trying to go back to acceptance of this unfair affliction and just determination that I will find someone somehow to help. I have been battling for years and its hard to keep up the fight, but we must carry on as I know in my heart we can get better. Hang in there! Send that doctor $5.00 a month while you seek out real help!
Take a Deep Breath and start asking everyone and anyone about someone they might know that is reputable and semi affordable. Also might talk to health food stores, so here in my area have really knowledgeable people. Good luck!!
I did think about having the blood work done at the internal med. doctor. I think now that Aetna may still cover the bloodwork and the bloodwork folks said that they would send me a copy of the bill to submit.
I received my denial letter from Aetna yesterday and it didn't say the "right" reason why I was denied. I should have been denied for out of network but the letter said because I had not gotten a referral. I called them and asked them and they said because I'm in an HMO it was an out of network denial. Ok I told them....but I'm a little confused because that's not what the letter says. Finally after going round and round the woman said that the rule is if you can't find a specialist in-network within 30 minutes from the house they will approve the out of network doctor. I told her that it wasn't displayed anywhere on the website, etc. and that when I called Aetna previously they never said anything like that... Hmm..... So, I left a message with the Internal Med. Doctor and hopefully he'll write a referral and I'm going to write up a letter myself explaining everything. If anything, it is worth a shot. Aetna said that if they wound up approving it it could be done retroactively.....wish I'd known this sooner.
I received my denial letter from Aetna yesterday and it didn't say the "right" reason why I was denied. I should have been denied for out of network but the letter said because I had not gotten a referral. I called them and asked them and they said because I'm in an HMO it was an out of network denial. Ok I told them....but I'm a little confused because that's not what the letter says. Finally after going round and round the woman said that the rule is if you can't find a specialist in-network within 30 minutes from the house they will approve the out of network doctor. I told her that it wasn't displayed anywhere on the website, etc. and that when I called Aetna previously they never said anything like that... Hmm..... So, I left a message with the Internal Med. Doctor and hopefully he'll write a referral and I'm going to write up a letter myself explaining everything. If anything, it is worth a shot. Aetna said that if they wound up approving it it could be done retroactively.....wish I'd known this sooner.
Just a thought. Why can't you get your blood work done at your internal med. doctor, so that it's covered by insurance, and see if the doc will at least consider extending your current thyroid prescriptions and keep you going until Nov.? If not, then you could at least take those lab results with you and return to the new doctors and avoid all that cost. There's no reason why the lab tests have to be done only at the new doctors' office. Do you think your internist might cooperate with you on this?
Well....I haven't spoken with my insurance yet but I am going to write something to them today. I know someone else who has my insurance but they have a PPO and Aetna (who I have but HMO Open Access) is going to cover 75% for these doctors. Do you know that I have referred 3 people to this practice???? And of course I'm the one who can't get the thing covered.
I have searched under the Armour website for new doctors under my plan. I found 2 in Virginia reasonably near me but I haven't called their offices yet.
My husband says that when open season comes we can switch to the insurance that will cover these doctors. That starts in early November. I guess if with the worst case scenario I can do a payment plan with this office - possibly do one more visit (see if I can get the blood work straightened out) and then switch to a different plan in November that will cover them?
Any thoughts?
I have searched under the Armour website for new doctors under my plan. I found 2 in Virginia reasonably near me but I haven't called their offices yet.
My husband says that when open season comes we can switch to the insurance that will cover these doctors. That starts in early November. I guess if with the worst case scenario I can do a payment plan with this office - possibly do one more visit (see if I can get the blood work straightened out) and then switch to a different plan in November that will cover them?
Any thoughts?
I'm going to give it a shot. In the meantime I'm waiting to hear back from them. At least I can talk about it today. On Monday I was way upset and crying, on Tuesday I was just downright mad, and today I'm trying to figure out my course of action. I'm still upset and mad but I have to do something.
I'm going to go check out that website and compare to the providers listed in my insurance.
I'm going to go check out that website and compare to the providers listed in my insurance.
Just had another idea for you. If you click on this link it is a list of doctors in your general area who have prescribed Armour thyroid at one time or another.
http://www.armourthyroid.com/con_phResults.aspx
You might consider interviewing some of these doctors in your vicinity and see if any sound like they can treat thyroid problems properly without robbing you blind. I think that doctors who have prescribed Armour tend not to be so rigid in their approach to treating thyroid problems. By this I mean that they might actually go beyond TSH and total T4 testing. Hopefully they listen to their patients' symptoms, test for free T3 and free T4 and medicate accordingly. What do you think?
http://www.armourthyroid.com/con_phResults.aspx
You might consider interviewing some of these doctors in your vicinity and see if any sound like they can treat thyroid problems properly without robbing you blind. I think that doctors who have prescribed Armour tend not to be so rigid in their approach to treating thyroid problems. By this I mean that they might actually go beyond TSH and total T4 testing. Hopefully they listen to their patients' symptoms, test for free T3 and free T4 and medicate accordingly. What do you think?
I emailed the billing department this morning for this practice and politely asked them to explain to me their billing process and if I could at least have a copy of the bill from the blood work to submit on my own to my insurance. We'll see what they say.
Here is my problem.... These are the ONLY people that I can find who actually CAN help me. But, I feel pretty screwed since I feel like they are taking advantage of the fact that they ARE the only folks around who know what they are doing. I want to go to them because of this....and don't want to go to them because of this. But I definitely cannot afford to go to them and have to pay for everything each time. I just can't do it.
Here is my problem.... These are the ONLY people that I can find who actually CAN help me. But, I feel pretty screwed since I feel like they are taking advantage of the fact that they ARE the only folks around who know what they are doing. I want to go to them because of this....and don't want to go to them because of this. But I definitely cannot afford to go to them and have to pay for everything each time. I just can't do it.
I live in Manassas, VA. But I am willing to travel at least a little ways if I had to.
Thanks for the response. I've been through 3 different doctors over the last two years and none of them listen to me with regards to my weight, fatigue, swollen joints, etc. This last $706 doctor said that since Levothyroxine wasn't working for me - she wanted to try equal dosing of the Armour. Then when she got my reverse T3 back she said that it was in the normal range but on the very low end so she is prescribing Cytomel.... My GP wouldn't even touch the issue of Hashimoto's. The endocrinologist says I'm in the normal range so I should be feeling "perfect". The internal medicine doctor said that my Hashimoto's and thyroid have nothing to do with mood or weight and that I need to face that I'm just getting older....I'm 34. I don't know who else to go to under my plan....I've looked and looked and read reviews and I can't find anybody.
Sounds to me like you have gotten mixed up with a doctor (s) that are more concerned with squeezing out every dollar they can get from patients, than in helping. I would insist that they bill the insurance company for lab charges from Fairfax. Surcharges on lab work don't strike me very well, either.
What were the test results that made your current doctor decide to change your meds to Armour? May be the best, but just wanted to understand why?
I think I would start again looking for a good thyroid doctor who listens to your symptoms and uses free T3 and free T4 tests to regulate meds, without overcharging you for the service. You might even try posting a message on this forum, asking if anyone knows of a good thyroid doctor in your area.
What were the test results that made your current doctor decide to change your meds to Armour? May be the best, but just wanted to understand why?
I think I would start again looking for a good thyroid doctor who listens to your symptoms and uses free T3 and free T4 tests to regulate meds, without overcharging you for the service. You might even try posting a message on this forum, asking if anyone knows of a good thyroid doctor in your area.
Thanks for the advice. I have insurance with Aetna. They won't pay for the bloodwork because the doctor is billing it to the insurance under themselves - not the lab.
Is your insurance refusing to pay because the Drs. are out of network? If so, try calling and ask for a GAP EXCEPTION. It has worked several times for me.
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