Question about Lab work quality

[Luke717]

I have good insurance. They cover all the tests Defy wants you to get, even the extra tests that aren't mandatory.
I am pretty sure LabCorp is who would run the tests, if I have Defy send me the script and get them done on my own.

Does Defy use a Lab that is better?

Does anyone know what the best route would be in this instance?
1. Pay defy to run the labs, which would mean I would get the blood work done and where I live the then they would sent it to Defy's lab for processing (I think that's how it would works).

2. Go get blood drawn, my insurance / Lab would send most to a local lab and then probably LabCorp for the speciality tests.

To clarify my question better. Is Defy's lab better than any other Lab? Is there any other benefit to just letting Defy handel it all?

 

[slicktop]

So first, Defy primarily uses LabCorp. I use my HSA, so I can't help you on insurance processing, but I think you'd have to pay for it and then submit it yourself to your insurance for reimbursement. If you have a full set of labs from Quest and they're recent enough, Defy will accept them in most cases. Easiest thing to do is to fire up google maps or LabCorps website and look for a LabCorp near you- chances are there's one close if you're in a major metro area. They're super easy to talk to though- I'd just call them and ask for guidance.

 

[Jason Sypolt]

We use LabCorp almost exclusively because they have the best combination of the most convenient locations in the most states and the lowest costs which we can pass on to patients.

When it comes to labs, you have some options:

1. Order through Defy and you will be emailed a LabCorp requisition order. You paid our low price and then you can go to any LabCorp Patient Service Center to get the specimen collected. We get the results when they are available and send you a copy.

2. Use your insurance. This is a great option IF your insurance will cover routine labs. There is risk if you are not 100% certain however, and you could be left with a huge lab bill if they deny coverage for some reason. We have you sign an insurance waiver stating that you accept the cost of labs if your insurance refuses coverage for some reason so that you understand this. We send you a prescription for the labs and you take it anywhere that you want. It's up to you to find and go somewhere in network. Send us the lab results when you get them (since it is not through our LabCorp account, it's outside of our system).

3. Bring your recent labs. This happens mostly for new patients. We will accept lab results no older than 90 days if they are equivalent to the labs that we require.

Options 2 and 3 can be from any lab, not just LabCorp. They need to be from 90 days ago or less, equivalent to our required labs, and on an official lab results document.

I have personally done the first 2 options. My insurance used to not only cover labs but I lived about 3 blocks from a small local hospital in network so I could walk there, get the collection, and walk back home in like 30 minutes for free. Couldn't beat that. Since I work at Defy and moved to Tampa, I just get a lab draw in the clinic easily, and the prices for the labs really are low. If your insurance doesn't cover them - and a lot won't, you will have a tough time finding lower prices. Our price for a CMP-14 is $15, and I used to see in my EOB when I lived in OH and used insurance that the local hospital would bill my insurance $232 for that same test. Insanity.

 

[Charliebizz]

We use LabCorp almost exclusively because they have the best combination of the most convenient locations in the most states and the lowest costs which we can pass on to patients.

When it comes to labs, you have some options:

1. Order through Defy and you will be emailed a LabCorp requisition order. You paid our low price and then you can go to any LabCorp Patient Service Center to get the specimen collected. We get the results when they are available and send you a copy.

2. Use your insurance. This is a great option IF your insurance will cover routine labs. There is risk if you are not 100% certain however, and you could be left with a huge lab bill if they deny coverage for some reason. We have you sign an insurance waiver stating that you accept the cost of labs if your insurance refuses coverage for some reason so that you understand this. We send you a prescription for the labs and you take it anywhere that you want. It's up to you to find and go somewhere in network. Send us the lab results when you get them (since it is not through our LabCorp account, it's outside of our system).

3. Bring your recent labs. This happens mostly for new patients. We will accept lab results no older than 90 days if they are equivalent to the labs that we require.

Options 2 and 3 can be from any lab, not just LabCorp. They need to be from 90 days ago or less, equivalent to our required labs, and on an official lab results document.

I have personally done the first 2 options. My insurance used to not only cover labs but I lived about 3 blocks from a small local hospital in network so I could walk there, get the collection, and walk back home in like 30 minutes for free. Couldn't beat that. Since I work at Defy and moved to Tampa, I just get a lab draw in the clinic easily, and the prices for the labs really are low. If your insurance doesn't cover them - and a lot won't, you will have a tough time finding lower prices. Our price for a CMP-14 is $15, and I used to see in my EOB when I lived in OH and used insurance that the local hospital would bill my insurance $232 for that same test. Insanity.

good to know I just started the process of becoming a patient this weekend. Very happy with the process so far.

just to clarify you can use your ins for labs even if your an out of state patient ?
Thank you for the info

 

[Jason Sypolt]

You can use insurance for labs if you are out of state, yes. What you should do is check in the online directory for your plan to find an in-network facility. I would also call the carrier to check and see if "routine diagnostics" are covered and have no co-pay and no deductible. When Defy issues a lab rx for patients to use their insurance, we use the routine diagnostics code to help patients with that process.

You could be one of the lucky ones, but what many plans are doing with testing is they have what seems like a low 20% deductible. But like I said in my post above, my plan was billed $232 for a $15 test. If I had to pay that 20%, it would have cost me $46.40 or more than 3x what Defy's price is. My plan at the time just paid for everything and the hospital billed them directly. I presented my lab rx and insurance card and was done. Some plans make you pay upfront and then reimburse you, and some have other ways of processing claims. Definitely call them and check.

I'm not trying to dissuade you, but I have seen that it is becoming more difficult to go through insurance for much of anything proactive/preventative. Some people can save a lot on costs with insurance for labs, but you really have to be careful. Insurance plans are never intended to save you any money. They are designed to protect against financial catastrophe and the carriers are making money off of you long-term by betting that you aren't going to have a large claim for a while and by denying as much as possible. They aren't your friend and aren't there to help you. Even when you do save money, you're still paying them hundreds or even a thousand dollars or more each month for the premium.

Medications are another matter. What Defy cannot do if you want to use your insurance is call in controlled substances like Testosterone for you in a state other than FL. You could try to get reimbursed for the cost of medications like T, but they almost all deny claims for T and they will most likely deny claims for other meds like HCG, Anastrozole, etc because those are prescribed off-label for TRT and it gives insurance carriers a reason to deny.

 

[Charliebizz]

So just to clarify you can

You can use insurance for labs if you are out of state, yes. What you should do is check in the online directory for your plan to find an in-network facility. I would also call the carrier to check and see if "routine diagnostics" are covered and have no co-pay and no deductible. When Defy issues a lab rx for patients to use their insurance, we use the routine diagnostics code to help patients with that process.

You could be one of the lucky ones, but what many plans are doing with testing is they have what seems like a low 20% deductible. But like I said in my post above, my plan was billed $232 for a $15 test. If I had to pay that 20%, it would have cost me $46.40 or more than 3x what Defy's price is. My plan at the time just paid for everything and the hospital billed them directly. I presented my lab rx and insurance card and was done. Some plans make you pay upfront and then reimburse you, and some have other ways of processing claims. Definitely call them and check.

I'm not trying to dissuade you, but I have seen that it is becoming more difficult to go through insurance for much of anything proactive/preventative. Some people can save a lot on costs with insurance for labs, but you really have to be careful. Insurance plans are never intended to save you any money. They are designed to protect against financial catastrophe and the carriers are making money off of you long-term by betting that you aren't going to have a large claim for a while and by denying as much as possible. They aren't your friend and aren't there to help you. Even when you do save money, you're still paying them hundreds or even a thousand dollars or more each month for the premium.

Medications are another matter. What Defy cannot do if you want to use your insurance is call in controlled substances like Testosterone for you in a state other than FL. You could try to get reimbursed for the cost of medications like T, but they almost all deny claims for T and they will most likely deny claims for other meds like HCG, Anastrozole, etc because those are prescribed off-label for TRT and it gives insurance carriers a reason to deny.

My insurance is pretty good with the labs. I was a patient of dr crislers and they covered the labs he required pretty well. The medication would be nice if it was covered but that’s just the nature of the beast. I can’t put a price tag on feeling. Good. Haven’t had much luck feeling well on trt as of yet but I’m hoping this time around I can. I figured a few things out that can be holding me back so we shall see

 

[Jason Sypolt]

So just to clarify you can

My insurance is pretty good with the labs. I was a patient of dr crislers and they covered the labs he required pretty well. The medication would be nice if it was covered but that’s just the nature of the beast. I can’t put a price tag on feeling. Good. Haven’t had much luck feeling well on trt as of yet but I’m hoping this time around I can. I figured a few things out that can be holding me back so we shall see

You are in luck then! Dr. Crisler was actually a provider at Defy for some time and had very similar lab requirements.

 

[Gman86]

So just to clarify you can

My insurance is pretty good with the labs. I was a patient of dr crislers and they covered the labs he required pretty well. The medication would be nice if it was covered but that’s just the nature of the beast. I can’t put a price tag on feeling. Good. Haven’t had much luck feeling well on trt as of yet but I’m hoping this time around I can. I figured a few things out that can be holding me back so we shall see

I’m curious, what are the few things that you think might be causing you issues?

I forget, have you tried the cream before?

 

[Charliebizz]

I’m curious, what are the few things that you think might be causing you issues?

I forget, have you tried the cream before?

No that’s the one thing I haven’t tried. Not sure I can commit to the 2x a day rubbing it on my balls lol. I got tired of androgel just one time a day real fast.

I just think I need to play with the dose and frequency a little bit. I’m low shbg but I don’t think frequent injections sub q are really for me that’s what I was doing last time. Plus the dosing. I think I need to try and be from 80-100mg per week. Anything higher I get too many sides any lower seemed to not give me much symptom relief. And trt with low dose lexapro is the only way I can even remotely handle trt. Without it I get major low cortisol symptoms and labs.

 

[Gman86]

No that’s the one thing I haven’t tried. Not sure I can commit to the 2x a day rubbing it on my balls lol. I got tired of androgel just one time a day real fast.

I just think I need to play with the dose and frequency a little bit. I’m low shbg but I don’t think frequent injections sub q are really for me that’s what I was doing last time. Plus the dosing. I think I need to try and be from 80-100mg per week. Anything higher I get too many sides any lower seemed to not give me much symptom relief. And trt with low dose lexapro is the only way I can even remotely handle trt. Without it I get major low cortisol symptoms and labs.

Honestly, I completely relate. I changed back to injections, for now, because i just had a baby, and was applying some of the cream to my forearms. It’s wasn’t really that bad having to apply the cream twice a day, but even once per day injections, which I’m on now, are way more convenient, imo. But honestly, I really really think you should give the cream a try. With all the issues you’ve had with injections, it might be E2 related. The cream completely eliminates any E2 issues, which imo, is one of the biggest reasons there is so much success with it. I, personally, felt the best I have, on the cream. And I was only on it for 2 months. A guy on a fb group just reported that it took him 3 months to feel amazing on the cream. He felt pretty crappy before that, and now feels unbelievably amazing. So if I were you, I would honestly at least give the cream a try, and ride it out for 2-3 months. I’m telling you, if you end up feeling amazing on the cream, and finally get TRT to work for you, you’re gonna be slapping that cream on ur nuts twice a day with a smile on ur face lol. It’s honestly not as inconvenient as u think. U go to the bathroom, pull your pants and underwear down, put some cream on those things, and pull everything right back up. Some will rub off on your underwear, but it won’t effect labs as much as you think. Plenty still gets absorbed. But when TRT just doesn’t seem to work, a lot of men have switched over to the cream and had great success. Not 100% sure why, but I’m assuming a lot has to do with the DHT boost, and how the cream eliminates the need to control or worry about E2, again probably due to the DHT boost, which opposes E2. On the cream, everyone’s free T is much higher than on injections, as well. So the improvement in free T to E2 ratio is probably another reason why men feel so good on it. If I were you, and were giving TRT another try, possibly for the last time, I would 100% try the cream. And I’ve literally been through every possible type of HRT there is, and that’s what I would do if I were in your position. Worst case scenario, u try the cream, don’t like it, stop it, it will be out of your system in a week or so, and you try injections again.

 

[Charliebizz]

Honestly, I completely relate. I changed back to injections, for now, because i just had a baby, and was applying some of the cream to my forearms. It’s wasn’t really that bad having to apply the cream twice a day, but even once per day injections, which I’m on now, are way more convenient, imo. But honestly, I really really think you should give the cream a try. With all the issues you’ve had with injections, it might be E2 related. The cream completely eliminates any E2 issues, which imo, is one of the biggest reasons there is so much success with it. I, personally, felt the best I have, on the cream. And I was only on it for 2 months. A guy on a fb group just reported that it took him 3 months to feel amazing on the cream. He felt pretty crappy before that, and now feels unbelievably amazing. So if I were you, I would honestly at least give the cream a try, and ride it out for 2-3 months. I’m telling you, if you end up feeling amazing on the cream, and finally get TRT to work for you, you’re gonna be slapping that cream on ur nuts twice a day with a smile on ur face lol. It’s honestly not as inconvenient as u think. U go to the bathroom, pull your pants and underwear down, put some cream on those things, and pull everything right back up. Some will rub off on your underwear, but it won’t effect labs as much as you think. Plenty still gets absorbed. But when TRT just doesn’t seem to work, a lot of men have switched over to the cream and had great success. Not 100% sure why, but I’m assuming a lot has to do with the DHT boost, and how the cream eliminates the need to control or worry about E2, again probably due to the DHT boost, which opposes E2. On the cream, everyone’s free T is much higher than on injections, as well. So the improvement in free T to E2 ratio is probably another reason why men feel so good on it. If I were you, and were giving TRT another try, possibly for the last time, I would 100% try the cream. And I’ve literally been through every possible type of HRT there is, and that’s what I would do if I were in your position. Worst case scenario, u try the cream, don’t like it, stop it, it will be out of your system in a week or so, and you try injections again.

it was something I also considered. I have a 3 week old and a 2 year old so I’m not really a fan transdermal. But I’m going to see what the dr thinks

 

[Gman86]

it was something I also considered. I have a 3 week old and a 2 year old so I’m not really a fan transdermal. But I’m going to see what the dr thinks

Sounds like a good plan. If you do the cream, just apply all of your dose to your scrotum, and you’ll be fine. Don’t waste your time applying any of the cream anywhere else. I really think you’d be doing yourself a disservice by trying injections again. What makes you think this time will be different? No sarcasm or judgment. Just curious what your thoughts are about this time possibly being successful with injections. Thanks in advance.

 

[Charliebizz]

Sounds like a good plan. If you do the cream, just apply all of your dose to your scrotum, and you’ll be fine. Don’t waste your time applying any of the cream anywhere else. I really think you’d be doing yourself a disservice by trying injections again. What makes you think this time will be different? No sarcasm or judgment. Just curious what your thoughts are about this time possibly being successful with injections. Thanks in advance.

well at a higher dose I had some improvements but the negatives outweighed the positives. On 120mg a week. My bp went up anxiety,snoring and trouble sleeping. At a lower dose I had some positives like pain relief and a better recovery from working out. But I felt like they started to fade. I’m thinking maybe if I’m on 80-100 things can get better.

I don’t know how comfortable I am with the scrotal cream. My understanding is that it’s not that you don’t drive up e2. It’s that the high dht counter acts it. And do we really know what high dht will do long term ?

 

[Gman86]

well at a higher dose I had some improvements but the negatives outweighed the positives. On 120mg a week. My bp went up anxiety,snoring and trouble sleeping. At a lower dose I had some positives like pain relief and a better recovery from working out. But I felt like they started to fade. I’m thinking maybe if I’m on 80-100 things can get better.

I don’t know how comfortable I am with the scrotal cream. My understanding is that it’s not that you don’t drive up e2. It’s that the high dht counter acts it. And do we really know what high dht will do long term ?

Exactly. My E2 was 79 sens, and 88 non-sens on the cream. The high DHT opposes E2 at some level. Maybe the receptors. All I know is that I’ve never seen or heard of anyone needing to control E2 while on the scrotal cream. Sounds like your issues could be due to high E2. So that’s why I think it may be advantageous for you to use the cream, because you may get all the testosterone benefits, without the side effects from the high E2. I completely agree though. All the top doctors that use scrotal cream say that there are no risks involved with having elevated DHT levels, and they may be right, but I personally want to see more data on the subject. I’m personally not too worried about it, but not super comfortable with it either.

But whether you try the cream, or injections again, I’m really glad to see that you’re giving it another go. I personally don’t believe that for some, HRT just isn’t for them. I believe that HRT can work for literally everyone, it’s just a matter of figuring out what works, and what doesn’t. For some, it can be extremely complicated, unfortunately, but never impossible, imo. There’s many options/ tools, in regards to HRT, that most guys don’t even know about, let alone utilize. So to be successful, for some, it’s just a matter of continuing to learn, and/ or finding a good doctor that knows his stuff.

 

[Charliebizz]

Exactly. My E2 was 79 sens, and 88 non-sens on the cream. The high DHT opposes E2 at some level. Maybe the receptors. All I know is that I’ve never seen or heard of anyone needing to control E2 while on the scrotal cream. Sounds like your issues could be due to high E2. So that’s why I think it may be advantageous for you to use the cream, because you may get all the testosterone benefits, without the side effects from the high E2. I completely agree though. All the top doctors that use scrotal cream say that there are no risks involved with having elevated DHT levels, and they may be right, but I personally want to see more data on the subject. I’m personally not too worried about it, but not super comfortable with it either.

But whether you try the cream, or injections again, I’m really glad to see that you’re giving it another go. I personally don’t believe that for some, HRT just isn’t for them. I believe that HRT can work for literally everyone, it’s just a matter of figuring out what works, and what doesn’t. For some, it can be extremely complicated, unfortunately, but never impossible, imo. There’s many options/ tools, in regards to HRT, that most guys don’t even know about, let alone utilize. So to be successful, for some, it’s just a matter of continuing to learn, and/ or finding a good doctor that knows his stuff.

i hope I can find the right protocol. I’m still very skeptical of the scrotal cream. But I will run it by my dr.

 

[Gman86]

i hope I can find the right protocol. I’m still very skeptical of the scrotal cream. But I will run it by my dr.

I hope you can too. When I had low hormone levels, I was existing, but absolutely wasn’t living. Before and after TRT is night and day, and I’m not even close to optimized, atm. But definitely soooo much better than prior to TRT with bottom of the barrel levels. So I feel for u and how much of a struggle everyday tasks can be with low levels, compared to those same tasks with normal/ high levels that end up becoming so easy to accomplish. You’ll get there. Best advice I can give is just don’t give up until u figure it out. Exhaust all options. And nowadays, there’s more options than ever, so if one protocol doesn’t work, there will always be other protocols to try.