This and That and Talk - My Transplant

Yes, that is correct, @hello1234. My PCP has to authorize m the Mayo (out of state) lab order. It is a simple process and I just drop the lab order with his nurse who calls me usually later that day or next day to pick it up. I take it to my local hospital/Clinic lab where it is placed on file as a standing order for whenever I need routine (or extra) labs drawn.

My lab results are faxed to my PCP as the ordering physician, and to the Mayo Transplant specified address. I don't have a Quest lab or a LabCor near me, so the hospital lab is my only option.
Does your PCP get a copy of your routine labs?

Hi @rosemarya 😊
I hope you are having a great day! Yes, my primary physician receives the lab results, but the nurses are not too keen about faxing to Mayo each time. (Many times, I ask for a hard copy print out, drive it over to my local UPS store and then pay for it to be faxed).

I have had a similar problem with the lab fax not getting to Mayo. I found out that the main lab holds the results and they go out the following day or when they get a batch. I have had to go to the main building and trek to the records department to have them sent again while I wait for a “received” response on the fax. The lab has told me too many times that the problem has to be at Mayo’s end. (I don’t do the blame game very well 🤨). Once I discovered that they were faxing to wrong address using a similar area code!
As a result I always return to the free standing lab building and pick up my results, just to check if sent to correct address. Luckily I’m now on a 3 month schedule. I used to copy and fax like you, but that got old real quickly. I even scanned and sent a copy via patient portal, but have been told not to do it that way because of an updated lab filing system that is not connected there.
So I think I have found a solution! It was the idea of the sweet nurse at the lab! She faxes it right there when I pick up my hard copy …and Mayo has it posted on my portal by the end of the day😃

Recently I got a notice that Mayo Rochester was using Quest because they arranged to connect electronically. I see some members are able to do it that way. However, I don’t have a Quest lab nearby.

I’m due for labs in a few weeks. I hopeful that my latest solution works, again. I’l let you know, and it might be something that could work for you 🤞

Thank you @rosemarya 😊 I love your new solution!! Please keep me posted on your success. I think I will try that with my next labs. My nephrologist office faxed a copy of an MRI that I had done, but it has not been added to my records on the portal. My nephrologist suggested that I now FedEx it to Mayo. (I don't know if that's a good solution or not for things like MRI and Cat Scans).

@roseymarya, do you have to let your Mayo team at Rochester know that your PCP will cc your lab results to them? I was told by the Az Mayo nurse that the provider who rewrites the lab order becomes responsible for reviewing the labs. So when Mayo receives the lab results they will show it's ordered by your local provider in which case they may not review them??? How does this work? Does the PCP cc the results and indicate that order was originally from your Mayo provider???

@caretakermom, This is confusing, isn't it!

-I take the copy of my lab order (written by my Mayo transplant team during my annual evaluation) to to my PCP when I return home.
-My PCP keeps the original, and he re-writes it because local facility will not/ cannot honor out of state lab orders (I think that is true for medication prescriptions, too).
-Since the original from MAYO requests that the lab results be faxed to a specific fax number at Mayo, he includes that "Send to" information.
-Both Mayo and my PCP get original lab results copies from the Hospital lab. No need for cc to anyone.
-Also I sign a Permission to Release Form so that the lab results can be sent to Mayo. I do that annually, too, when I deliver the new lab order.
-My standing lab order and release of information are kept on file at the lab location on the southside of town where I prefer to go.

I am not connected to a huge hospital, so maybe things are handled differently here.
I hope this makes sense!

So the specific question I'm asking is since your PCP had to re write the lab script, when Mayo gets the lab results from the hospital, do they know they are supposed to review the lab results? Because the re written order has your PCP as the ordering physician. I'm just concerned that Mayo gets the lab results but may not review because it won't show they are the ordering physician, and thus they are responsible to review the labs. Does it make sense what I'm asking? This is what the Mayo nurse told. Whomever orders the labs will be responsible for reviewing the labs. So when Mayo gets the lab results they may not know to review them because the ordering physician is someone else!!

I think that the terminology is confusing.
The ordering physician for Mayo/ transplant purposes is the transplant doctor who ordered the specific labs to monitor my post transplant health and to adjust meds if indicated by lab levels. It is unreasonable to expect a primary care doctor to know what labs or lab levels that my organ health requires. That is why I have an annual evaluation my transplant team about my transplant health.
I first returned home after my transplant, my first agenda item was to make an appointment with my primary care doctor to make sure he would work with Mayo transplant team to coordinate my care locally. Even contacting them when necessary.
For the lab, the local doctor is the ordering doctor because he is in-state legal physician.

I hope this clears it up.

@rosemarya, just an update. My BCBS insurance contacted me and says that Quest is in-network for both California and Arizona so I'm glad that's cleared up. I think it worked out because they are border states.
Regarding your follow up with Mayo Rochester, how often have you been going to the annual checkup at Rochester and what labs and procedures do they run? Do they still run the same labs/procedures as they did the first year? The one-year checkup at Mayo Az is the same as the 4-month check up. I believe the 2nd year check up is the same as the 1 year. Then the 3rd year checkup is just a remote appointment.
At Mayo Az, they follow the patient for up to 3 years only and then they sort of "kick you to the curb". No more follow ups after the 3rd year at Mayo Az. I'm hoping that they will agree to see the patient if after that time, there is urgent issues regarding the health of the kidney that the local neph cannot handle. The local transplant center here(UCLA, Cedar Sinai) are reluctant to take patients from out of state. They will refer back to where you got transplanted!! Looking forward to your inputs. Thank you!

@caretakermom
It is great to hear that you have received this positive update about Quest being in-network for your California and Arizona providers!
My annual visits are going to be different that yours. I have a double transplant - liver and kidney. It was a simultaneous transplant (1 donor, 1 surgery, 2 organs). As a result I am under the care of 2 departments! Mayo Clinic coordinates the care so that both departments work together and I'm not even certain which labs/procedures are for liver and which are for kidney.

I do not know the process for places other than Mayo Rochester where I had my transplant. But it sounds like you have some valid questions about future follow-up care. The best resource will be your husband's current transplant team because only they know his medical history and his medical needs. The question about whether you can be referred back to the original transplant dept is a good one. Add it to your lost of questions for your next visit.