Chris Giunta - Heart Valve Journal

My Journal

2366 days ago

I am 8 yrs. post aortic valve replacement. I elected to have a tissue valve. Earlier this year I was diagnosed with a fib and put on Xarelto. All of the ...Read more

I am 8 yrs. post aortic valve replacement. I elected to have a tissue valve. Earlier this year I was diagnosed with a fib and put on Xarelto. All of the commercials & pkg. insert say "not for people with artificial heart valves." I called Janssen and talked to several people to clarify "artificial" - does it mean mechanical, tissue or both. I did not get a definitive answer. When I questioned both my cardiologist and the electrophysiologist who performed an ablation about this warning they were not concerned. Does anyone have any insight into whether or not it is safe to remain on these new blood thinners if one has a tissue valve?

Kelly Stoll Hi Chris. This actually came up in my appointment with my GP yesterday. I have an Ony- X valve and we ... Read more

Kelly Stoll Hi Chris. This actually came up in my appointment with my GP yesterday. I have an Ony- X valve and we were discussing my long-term need for blood thinners. He suggested that Warfrain, in my case, is recommended because while there are newer medications available (like Xalrelto), they haven't done enough studies on them yet with mechanical valves. I am not sure how accurate this information is or if it will help. I do encourage you though to be your own best advocate and if you aren't getting an answer to your questions, keep asking. May you find the answers you seek soon.

Chris Giuntaposted an update

3108 days ago

Has any one with AVR had trouble getting insurance approval for echocardiograms? I am 5 yrs. post-op and all of a sudden I've been getting denied. I would ...Read more

Has any one with AVR had trouble getting insurance approval for echocardiograms? I am 5 yrs. post-op and all of a sudden I've been getting denied. I would think just the fact that I have an artificial valve is enough of a reason but apparently because there has been no change in my health, they wouldn't approve. I have BC/BS.

Franklin Wyrick Wow! I never thought they would deny an echo for an avr patient.

Joanna Prisiajniouk Is it the deductible factor that needs to be satisfied first?

Nap Garcia Are they declining coverage before you have the echo done? Or did you have the echo done already and ... Read more

Nap Garcia Are they declining coverage before you have the echo done? Or did you have the echo done already and they are denying coverage and therefore sticking you with the bill? I hope it would be the earlier, at least denying before the procedure. And is the provider notifying you of the denial or is BC/BS directly notifying you?

Cathleen Weed HMO or PPO? That's ridiculous. I get one every year. I have a PPO.

Jean Raber Sometimes it depends on how your doc writes the order or if he's ordering one more than once a year. ... Read more

Jean Raber Sometimes it depends on how your doc writes the order or if he's ordering one more than once a year. Call the doctor's office and see if they will go to bat for you. I also have BCBS, am on an HMO. My cardio stuff gets covered, but my oncologist is always having to fill out paperwork and argue with them. If it looks like you're going to cost money, they'll throw up roadblocks. I'm grateful to have ANYthing after five years of no insurance, but it's still a far from perfect system.

Lilly Black I would absolutely follow up with that! My PPO plan writes it up as preventative like when you would ... Read more

Lilly Black I would absolutely follow up with that! My PPO plan writes it up as preventative like when you would get mammogram. I get an Echo every year, $0.00. My plan is United Healthcare PPO. I hope you get it figured out!

Nap Garcia I wonder if anyone had difficulty getting a surgery pre-certified. Would hope those who have severe c ... Read more

Nap Garcia I wonder if anyone had difficulty getting a surgery pre-certified. Would hope those who have severe cases where repair or replacement is needed it wouldn't be an issue with insurance, as surgery is 10 to 20 times more costly than an echo I would imagine.

Chris Giunta I was declined before having it done, so went a year without one. I have BC/BS PPO and up until 2 ye ... Read more

Chris Giunta I was declined before having it done, so went a year without one. I have BC/BS PPO and up until 2 years ago was getting them annually with no problem. I was told it was denied because it wasn't medically necessary since the cardiologist wrote there was no change in my health.

Jean Raber Chris, I would call the cardiologist's office and explain the problem. There's probably a way he can ... Read more

Jean Raber Chris, I would call the cardiologist's office and explain the problem. There's probably a way he can write the order to indicate that this is a "degenerating condition" or something. Damn red tape, grumble, mutter, grouse ...