Nephro and dialysis center

[Lulu]

Does anyone know if it is true that if you don't go to the center you neph is associated with that you have to change nephs to the one at the center you go to. That is what I was told by the two different dialysis centers and from a staff member at my nephs office. My neph is nearly 60 miles from me. I keep him because I love him and he understands me. My dialysis center down the street said if I went there I would have to use their neph and not mine? I am working on getting home hemo through an agency but might not get approved in time.

[Joe Paul]

When I was looking for a closer clinic, all the clinics I talked to said I would have to use the Neph associated with that clinic. I would call various clinics and see what their policy is.

[JerseyGirl]

That is how it is done; you'll have to switch to the neph at the clinic you are dialyzing at.  You can ask your present neph to apply for admitting privileges at the unit closer to your home - admitting privileges are easy to get for an MD - and then he can cover you at the new unit- unless he is unwilling to travel that far.

[glitter]

my husband can use any neph he wants at his clinic now, to train on nxstage he would have to change to a davita clinic, and they said we would have to give up his current neph for one of theirs.- It is actually one of the reasons he will not switch-we want to decide who his Dr.s are....not the clinic.

[aharris2]

That is how it is done; you'll have to switch to the neph at the clinic you are dialyzing at.  You can ask your present neph to apply for admitting privileges at the unit closer to your home - admitting privileges are easy to get for an MD - and then he can cover you at the new unit- unless he is unwilling to travel that far.

This is in response to the comment "unwilling to travel that far". Our nephrologist never comes to the dialysis unit. Instead, we go see him once a month in his office. He does have privileges at our clinic and is always available by phone. Our appointments at his office are private and, more often than not, we spend 25 minutes with him, only him - talking, discussing problems and treatments, and not just focusing on kidneys. He is a phenomenal doctor and we would never give him up.

Ours is a Davita clinic and visits at the unit by the neph are not necessary (or even desirable in our opinion). So, go for it, ask the neph to get privileges at the closer unit and then go to his office for regular follow up.

[livecam]

Everyone's situation is different depending on what insurance coverage they have, where they live, and other factors.  In my case I'm covered by an HMO but dialysis services are contracted out to private dialysis units.  I had my HMO nephrologist, 3 staff nephs at the dialysis unit, and a transplant neph at UCLA.  Nephs everywhere, nephs coming out of every ear, a neph a day...you get the picture.   In your case it sounds like the dialysis unit you want to use has an arrangement with the nephrologist they want to send you to.  If push came to shove I'm sure you would get your way if you wanted someone else.

[ssticker]

Everyone's situation is different depending on what insurance coverage they have, where they live, and other factors.  In my case I'm covered by an HMO but dialysis services are contracted out to private dialysis units.  I had my HMO nephrologist, 3 staff nephs at the dialysis unit, and a transplant neph at UCLA.  Nephs everywhere, nephs coming out of every ear, a neph a day...you get the picture.   In your case it sounds like the dialysis unit you want to use has an arrangement with the nephrologist they want to send you to.  If push came to shove I'm sure you would get your way if you wanted someone else.

Kind of scary tho-neph has not been in since 10/02 07
I always ask
They just say-whatever is on the print out.
And they seem insulted when I make them pull my chart and read the Dr.s orders.

[livecam]

And they seem insulted when I make them pull my chart and read the Dr.s orders.

Don't think I would get along with those people.

[Rerun]

I think it is bull S*** but it is true for Sacramento.  If you choose a clinic you get their Neph.  If you choose a Neph then you go to one of their clinics.  

The reason is that if you have 10 Nephs in one central doctor's office they don't have time to run around to 15 different clinics, so they each take a couple of clinics and treat the patients there.

I think if you don't like the neph that treats your clinic then you should be able to make an appointment with the neph of your choice and go to his/her office as if you were a home patient.  Home patients go in once a month to visit their nephrologist.

[JerseyGirl]

I'm wondering how the neph gets reimbursed if he doesn't see his patient while actually on dialysis.  MD's are paid on a tier depending on how many times they see the patient each month - at least with Medicare, not commercial insurances.  I thought that the neph HAD to physically see the patient on tx to bill.  Many your neph is altruistic and doesn't bill medicare - otherwise it could be taken as medicare fraud if he does.

[okarol]

Jenna had a nephrologist at her first transplant hospital, and he has remained involved with her care before and during dialysis and after transplant (which took place at a different hospital) - we just never stopped seeing him even though she was assigned a new nephrologist at the dialysis center. We just asked that all the labs from in-center be faxed to him monthly. It was good to have more than one neph looking out for her.