I don't know how all the "free" COVID tests work. In particular, the insurers have made it VERY clear to us that they will not pay for COVID testing when required for work, school, or travel. They review our charts and deny every visit where such a reason is mentioned.
The tests we bill for have to be "medically necessary." They will even take back money they previously paid us when they find out it was done for one of those reasons. But these "free" testing sites are billing insurance too, they just don't generate a medical chart.
You can apparently get a "free" PCR test for your flight to Aruba. I don't know if the insurers just don't care when Walgreens or one of the drive through sites does the test, or if at some point they will be coming after them for the payment for these tests.
I would be glad to offer no-questions-asked free tests too, but it has cost me money, so I cannot. So patients get angry at us and they try to lie to us by saying they have a scratchy throat or something, right after telling us they just needed a test for their flight.
I don't like being put in the middle between them and their insurance company, but it happens every day. I don't make the rules, I just try to follow them.

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More from @Jim__Jackson

12 Sep
The word equitable made it so. I don't think it's "equitable" to withhold medication from the areas that need it most. I don't believe that there is a shortage. I believe that this action was politically motivated to further the political agenda of the current administration.
The order to the HHS to ration this medication came from high level politicians, not from physicians. I do not believe the manufacturer or the distributor was involved in the decision, but their hands are tied because it is the government who bought all of the medication.
The way I see it, they had three options: 1) leave things the way they were and trust the company when they said they have the ability to manufacture all the doses that were needed. This wouldn't have helped their agenda to mandate vaccinations.
Read 8 tweets
11 Sep
Now the freestanding ER we were referring patients to get the monoclonal antibody infusions called us and told us to stop sending them patients. Apparently they only have one monitor and can only do one infusion at a time. So I have more capability than the ER does.
We are going to ask them if they will give us some of their medication if they aren't going to use it.
I have three IV pumps so we were running three infusions at a time. The patients don't even need cardiac monitoring (but we have three of those too).
Read 4 tweets
11 Sep
Still no antibodies today. It seems that they won't be sending more. I've referred several patients elsewhere but it's very frustrating not being able to offer the most effective COVID treatment to them. I reached out to the distributor but haven't gotten a response.
Order status: cancelled
Update: We currently cannot provide an ETA on when you will receive a shipment. Once HHS approves your order request, AmerisourceBergen will ship the order.
Due to high email volumes, we kindly request that you do not email tracking requests.
Read 4 tweets
8 Sep
So the manufacturer cancelled my order of monoclonal antibodies. I have one day supply remaining. I placed an order via the appropriate link two days ago but didn't get a response, so yesterday I tried to order directly from the manuracturer and today I got this:
"Hello –

You’re receiving this email because your facility recently placed an order for C19 Therapies via the AB order platform. Please note that HHS is now reviewing every mAb order submitted and has advised that all mAb orders must be placed via the direct order link below"
"Due to this new process, we have been directed to cancel any orders received via the AB order platform. Please feel free to resubmit your order via the link below."

I resubmitted my order via the link provided, but now I will likely run out before delivery. If I even get it
Read 5 tweets
8 Sep
I see that there is a lot of interest in monoclonal antibody infusions, so I will discuss our process for administering them. I think it is a great treatment with very little downside.
We are giving the infusions to patients diagnosed with COVID and to high risk patients with exposure (spouses mainly). Here is a fact sheet from the FDA discussing the treatment and the qualifications for receiving it. We generally follow these guidelines.
Since Medicare supposedly pays for these infusions, the out of pocket charge for Medicare patients is zero. Private insurers are not required to pay for monoclonal antibody treatment, and because it is still considered experimental, they almost certainly will not do so.
Read 13 tweets
7 Sep
The reporting process required to obtain monoclonal antibody is extremely tedious. They don't just want to know how many doses per week we are using or how many we have on hand. They ask dozens of questions about our other supplies, and they require weekly updates.
They require submission of a CSV file with these data, most of which would only apply to hospitals. But they want to know how many gloves and masks and goggles we have on hand and how many days each supply is expected to last.
Whether we are experiencing staffing shortages. Whether or not we are having trouble purchasing masks, gloves, gowns, etc. How many influenza admissions we have. How many ventilators we have. Whether we have ventilator supplies and medications. How many hospital beds we have.
Read 7 tweets

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