Wednesday, July 2, 2014

A Paper Trail Leads To A New Pump

As I begin to write this, my thoughts start to form in a script for a bad Wilfred Brimley Dia-Beetus commercial.

"Attention People Living With Diabetes:  Have you or a loved one needed dia-beetus care through an insulin pump?  If so, please send us proof of your diabetes, including a two-month blood sugar log, an explanation of why you are worthy for our brand of insulin pump and a pint of blood.  Oh, and do not forget to include a check written to me, Insulin Pump Provider, for One Million Dollars."

As I roll my eyes while typing this, which is of course the ultimate in childishness behavior, I can't help but feel annoyed by the amount of work and effort that it takes to go into another insulin pump.  

In the same vein of childish behavior, it seems wrong for the pump/insurance companies (and they all do this) to demand redundant, time-consuming paperwork.  A two-month log of blood sugars, a list of reasons of why our out-of-warranty pump is not working, a letter from our endocrinologist stating need, copies of A1c results and the list goes on.... all for a child who is clearly still using insulin.  Even more insulting, she already has been on an once-before-approved insulin pump.  What could have possibly changed?

She still has type 1 diabetes.

And we are part of the lucky group because we have doctors that will type the letters and fulfillment companies that will stay with our order until it goes through.  I even think of my daughters as being blessed because mom and dad have a good grasp on the medical lingo and can decipher what is being said.

But what if you don't?  What if your doctor is not familiar with navigating the ins and outs of insurance and pump manufacturers.  What if you are left to order a pump on your own and worse, what if your not prepared to decode the various roadblocks and understand that not every 'no' really means NO.

What may be helpful if you are just venturing into this world of durable medical equipment, is to reach out to an advocate or a mentor.  Either through JDRF, ADA, or even on Facebook Closed Pages for chatgroups that have people pumping with the same type of insulin pump.  These are groups that have been there/done that and are a great resource.  A quick Facebook search should land you on several.  

After you have a handle on how others went through the process, form a list of questions for your insurance company and see if you can get answers in writing before you agree to purchase the insulin pump.  Some pump companies have representatives that will also help in researching your qualifications before you buy.  It may be best to enlist the help of both the rep and direct call the insurance company to ensure that you are getting a complete story.

Finally, follow-up with your endocrinologist or prescribing doctor if you have a pump held up in the ordering process.  In larger practices, it is not uncommon for paperwork to slip through the cracks.  A reminder call of what is missing can make all of the difference.  By being an advocate for your family, you can make the ordering process run as smoothly as possible.

And ultimately, avoid some childish eye-rolling!  






2 comments:

Need A Nap2 said...

I honestly don't know how anyone would fill out paperwork and get a pump! I'm so thankful for my daughter's endo and the work they put in for her first pump and then last year for her second pump. I'm thankful to the Medtronic rep who is trying to help me get the 530G with Enlite. You're right, sometimes no doesn't mean no. I'm trying to gently push forward on the process when I can. The rep said it is harder this year than last year! I've also heard that from OmniPod - even last year was harder than the year before. I love pump and CGM technology but I do wish it was cheaper and easier. :)

Naturally Sweet Sisters said...

I am so with you NAN. Seriously, cheaper and easier would be better. Fingers crossed for you too. It seems like a lot of us are in the same boat right now. Let me know how it goes if you get a chance and I will do the same. Right now, no news... sigh. Impatient! :)