Byram and the dme nightmare

has anyone on medicare used byram? i had a nightmare of a process reordering with them and i had to go 45 supplies with no cgm because of some bogus paperwork holdup. i have heard more nightmare stories about ccs and edgepark so i called medicare who suggested a new company wellstart. they seemed great so far i just want to have a backup plan just in case this ever happens again. i went through the forum and cant seem to find one person saying anything good about their supplier :confused:

My wife has been using ccs for tubing and Edwards for the Libre for years and never a problem

The reorder for Edwards always takes less then two minutes and CCS is done online

why both?

I’m sorry you had trouble, but I actually love Byram. I’ve had nothing but great experiences with them so far. The one time I had a holdup processing script renewals, I called customer service and told them I would run out of supplies and they were risking my life, they over-nighted me three changes worth of pump supplies.

I fully believe it has everything to do with the quality of the reps you wind up working with, and little to do with any one particular company. It seems like there’s wonderful and terrible reports for all of them.

She was using CCS for tubing and when Medicare approved the Libre I went online to see who had it and Edwards came up. So I looked at reviews and went with them - they have been excellent and usually answer calls within a minute. I really don’t know if CCS had the Libre at the time, and I don’t remember if I checked. I would have no reason not to go with them, but I just do not remember. Good question thou.

thank tony. ok good to know. i havent heard of edwards but ccs scares me a bit

youre probably right robyn. it just took 40 days to get my next order and i had no supplies during that time. so i want to be prepared

I have used CCS for 4 years with no problem. My Endo’s staff are great when processing paper worked required by Medicare.

Byram has been fantastic with me since the switch over from Edgepark. My CGM supplies are auto-ordered with the exception of the transmitters which I need to manually order every 6 months. Their reps have been great every time I have called.

thanks for the input i guess it sounds like everyone can have their own, and very different, experience with any supplier. guess i need to take these negative views w a grain of salt but i was just so upset with my experience. cheers

I think it also depends on insurance and doctors office in communicating what info is needed, and how quickly it is provided. I had great service with Byram, and online reorder and making payments was very easy.

One issue I had was related to timing and my deductable. So they overcharged me by using an out of date balance on my deductible. Took several calls to convince them a mistake was made, and then a 3-way call with insurance.

This has been a bit more of a problem of late. According to my DexCom person, Byram did a massive upgrade to their computer system (I think it was computer) and there have been difficulties. I deal with a lot of different suppliers and Byram is no worse or better than then another “major” suppliers for the most part (at least up until a couple of months ago). I personally like CCS Medical and have for years. Just had a problem come up with them and they fixed it quickly.

Being that you are on Medicare, I doubt that the paperwork issue was “bogus”. Medicare paperwork for test strips and CGMS are a BEAR!!. Medicare auditors are very liberal in their interpretation of what is require in documentation so many suppliers and pharmacies get their money take back over things that really aren’t required but it is how the auditor interprets it. These “take backs” are part of the reason why some pharmacies, CVS being a major one, that will not give a person more test strips than exactly what Medicare "allows’. Medicare’s general rule of thumb for test strips is 1 time a day if you aren’t on insulin and 3 times a day if you are on insulin. You can do more but that is where the paperwork comes in. The pharmacies have been burned so many times by the Medicare auditors that they will ONLY supply 1 time a day in not on insulin or 3 times a day if on insulin, no matter what your doctor writes.

CGMS is similar. The wording in the document has to be exact. The slightest variation may result in them not getting paid. It can be as simple as using the words “has been” vs the word “is”. For instance: “The patient has been on four shots a day of insulin, and has been for the last 60 days.” vs. “The patient is on four shots a day.” The medication list may say: “Humalog 4 units with each meal and Tresiba U100 20 units at bedtime” but it doesn’t say anything about in the “discussion” section. That could also get it kicked back.

My best advice would be that your provider should put in each visit note:
“Mr. Parker is currently four shots of insulin a day. He takes a bolus injection with each meal and basal at night. This has been on this regimen for at least the last sixty days. He is currently using the DexCom G6 (I’m assuming) to monitor his glucose and he adjusts his insulin dosing accordingly based on those readings.”

The doctor also has to PHYSICALLY sign and date it. (I think some electronic signatures are okay but you can’t go wrong with a physical one).

That SHOULD be sufficient, as least as it stands now.

They have to provide these notes every six months, or there abouts. You have to be seen within that six month time frame. You are a day late and they won’t fill your supplies. If you are on an insulin pump you have to been within 90 days. Again, if you are day late and it is time for documentation again, no supplies until you have been seen. Medicare is very BLACK and WHITE.

My Byram experience has been good. But I’ve only gotten two orders from them, one being my new pump in November and the other being my supplies in February. Nothing to cause me to nominate them for a Nobel prize, but competent and timely. And I could understand the person on the other end of the line.