Monday, July 13, 2009

Insurance Frustrations

Here we are again....more insurance venting :(

Last week, I got a call from Cozmo telling me that they are no longer carrying insulin pump supplies and I need to choose a supplier (DUHHHHHH!) so they gave me Liberty Medical and the number. I called them and set up an account. The nice guy said they would call me back if there was a problem. On Saturday, I got a call... "Mrs. West, unfortunately we are not a participating provider. You will need to call your insurance company to find a supplier that is in-network." AHHHHHHHHHHH!

So, this morning I make the dreaded phone call to United Healthcare. The computer that answers my call couldn't understand me and then asked me to take a brief survey...HELL NO! Now I wish I had said yes so I could tell them what I thought about their company! Anyway, the lady that answers the phone asks me all the usual questions...ID number, name, birthdate...I was wondering when she was gonna ask for my underwear size...geesh! I explain that my daughter is on an insulin pump and we need to find a company that is in-network that carries the supplies she will need to continue pump therapy on her Cozmo pump. She gives me 2 phone numbers.... Apria and MiniMed. WTF? MiniMed? For Cozmo pump supplies? So I hung up and called the 1-800 number for Apria. I could barely understand her because she was of foreign decent. She said I called the wrong number and transferred me to a local number that takes care of infusion therapy. The lady on that number, which once again I can barely understand, tells me they deal with IV therapy not insulin pumps. So she gives me the number to a place that can help me. Wrong! The lady tells me they dont carry those supplies and they are durable medical equipment (DUH again!). So she transfers me to the DME line....the call ends. UGH! Thankfully I got the number before she transferred. I call them back and the guy is totally clueless as to what I'm asking for. He tells me for diabetes supplies then I need Star Medical and gives me the number. GRRRRRR! By now I'm really frustrated! I call Star Medical and the lady tells me that they don't carry anything for insulin pumps. Great! Just great! So this means I have to call back to United Healthcare. *sigh* I make the dreaded call back and speak with a nice mannered man. He apologizes for the wild goose chase I was sent on. I told him what I needed and he tells me that I have to go through another number. He stayed on the line until it was transferred. A really nice lady answers the phone. Once again, I tell my story and give her all my info. She gives me a list of suppliers that are in-network. Apria being the first....HELL NO! I told her I refused to speak with anymore Apria reps because I couldn't understand them. She giggled and said she completely understood. She told me to try Edgepark. She said they had a good name and she knew for sure they carried what we needed. *sigh* So I hung up and with a knot in my throat I called Edgepark. Within a few minutes I was speaking to a really nice woman and I explained everything I'd just gone through trying to find a supplier. She laughed and said well you're at the right place! She took all my info...told me she knew all about the Cozmo pump and Smiths not carrying the supplies...sympathicized with how frustrating it was....told me I was the 3rd Mom in the last hour that had a child that tested their blood sugar 10-12 times a day (so sad!) ...and asked me which sets we used? She also suggested we ask for 2 boxes a month instead of 1 because in summer heat and pool water they didn't stick as well and we needed room for bad sets as well. They come 10 in a box and if we change every 3 days thats just enough for 30 room for error. It made me wonder...was she just a good rep or did she have diabetes too and knew EXACTLY what we go through? It really didn't matter. I was just thankful to speak to someone that knew what we were talking about! She said she would call me back if there were any problems but she knew they were in-network so she didn't forsee any issues.

Whew! Why does everything with insurance companies have to be so difficult? If you say you need insulin pump supplies then they should be able to pull that up and give you a number to issues. But can't be that simple. And if you're a telephone rep for the USA then one of the qualifications should be...YOU HAVE TO SPEAK GOOD ENGLISH and CLEARLY! I'm sorry. I'm not against foreign speakers but if you're a rep then you should be able to talk clearly and properly so the person on the other line can understand you.

~gets down off my soapbox now~

Sorry for the vent. It's just frustrating that we have to jump through all these hoops when we shouldn't!

Anyone else use Edgepark?


Rachel said...

LOL I sooooooooooo understand your frustration!!!! My insurance company would only allow us to check Tristan's blood sugar 6 times per day!!!! We had to jump through hoops and get his doctor to write a letter of Medical necessity and all that crap just to get what we needed to take good care of him. It is so frustrating!!!!

I don't know anything about your company sorry. :( But they seem to know what they are doing which is great!

Shamae (Ghost written by Loren her hubby) said...

Oh insurance woes are not fun. If I can't understand the rep I just ask to be transfered to someone else. It is too confusing otherwise. I hope you like Edgepark and you don't have to go through that again!!

Anonymous said...

I use EdgePark now for both my Dexcom and Cozmo supplies and I have had absolutely ZERO problems with them. Everyone is so helpful and nice. I definitely recommend them. I wish your insurance company would have just sent you there first instead of having to go through all those other crappy companies.

Wendy said...

We use Edgepark as well and have only had a few minor probs that were fixed in a timely fashion -- and we never had to worry about not having enough in the meantime.

We've been using them since Addy started pumping 2 1/2 years ago because our insurance wasn't contracted with Smiths.

I also would have sent you straight to them had I known you were looking!!!!

What sites are you using?

Jill said...

Rachel~ The lady I spoke with that gave me Edgeparks number told me that if they didn't carry what we needed then to call her back and they would write something in our insurance stating the supplies we need are a medical necessity and there is no company in network that carries them and so they would pay for an out of network company to cover them. Thankfully we didn't have to go through all that mumbo jumbo! :)

Shamae~ I shoulda asked for another rep! I didnt think of that.

Thanks Amalas :) It's good to know they're a good company. This is the first time we've had to order supplies since we got the shipment from Cozmo.

Wendyyyyyyyy LOL I guess I shoulda spoke up sooner, huh? Kacey ended up sticking with the Comfort Shorts and the Cleos. She does the Cleos when she feels like doing them herself in between using the Comfort Shorts. They only stick 1-2 days on her and we've tried everything to keep them on and nothing works to hold them longer than 2 days but she likes the fact that she has the option of doing those herself rather than letting me do them. We tried the samples we got of the Inset 30s and our CDE was right....Kacey ended up not liking the automatic inserter. So once she's a bit older then we'll try something else that she can do on her own but for now, she loves the Comfort Shorts and I'm comfortable doing them. A site change can be mastered in less than 10min with those and it's quick and easy. She prefers them on her hip and we get better blood sugars with them there. She will only put the Cleo on her tummy even though I've tried to convince her to try her hip...LOL! I'm hoping to convince her soon to try it :)

Shannon said...

That sounds like it was rough! So sorry you had to go through that!

So hey I sent you a shout out on my blog. You should go check it out! LOL!

I hope Kacey is doing well and enjoying the summer! When does she get her cast off? LOL!

Beth said...

We use Edgepark too - both for pump supplies and CGMS. When we were trying to get Meg's first pump, we had some problems with them, ended up using another company for about a year, and then had to go back to them because no one else on my plan carried what we were looking for.

Edgepark was key in getting the Navigator for her this past winter; I had given up on the fight because we kept hitting brick walls at every turn. Ever since then, we've had great service from them. Hope they work out well for you, too!