So, after I last “talked” to some of you, I move my Dex RX to Adapt and got everything done in half an hour. I filed a feedback email with Walgreens. The problem store called today and said Walgreens has their own Medicare dept and it takes longer to get Part B like sensors from them because it’s not the same channel other suppliers go through.
True or no? Anyone have any idea???
True but the problem wasn’t that it took too long. They were saying you were denied because they were running your old insurance. Did they take any responsibility for their mistakes?
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They too k no responsibility for running the wrong card, they didn’t apologize for not returning my calls. They also said they take longer because they have their own department for Medicare and approvals take longer. She said they told me on the phone, but they didn’t. And she said when we did the three way call where Medicare called them and wanted me on the line, that Medicare didn’t realize things had to be run through Walgreens Medicare department. To which I responded that they never mentioned that to me or Medicare.
So I got Medicare labeled supplies from Adapt and they did the order in 30 minutes or less. This was going on nine days. Plus they said they might need more paperwork from my CDE who had already sent things twice.
Sounds a bunch of excuses to me.
We have no Walgreens where I live but we do have a WalMart. They gave me the same runaround that you got. I found a small pharmacy in town that was happy to handle Medicare Part B Rxs. I think that Part B pays less to the pharmacies and the large ones don’t want to bother with running Rxs through Part B because of it. If Medicare has a program, then I believe that ALL pharmacies should HAVE TO use it for people who qualify. Apparently they don’t. None of the government programs seem to run logically. Pity.
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Well said. I agree! And I tried to tell the girl, how am I supposed to know Walgreens has a Medicare department. All I did was call national Medicare and spoke to DME supervisors. That should have covered everything.
Obviously I meant it should be enough to have one agency not a Walgreens Medicare dept. I told her she needs to tell people that they have that division and things could take awhile. I moved my account back to Adapt Health and it was done in half an hour. However they have been keeping my records and asking how often I see my CDE for several years. I also saw this from Walgreens:https://l.facebook.com/l.php?u=https%3A%2F%2Fdrugstorenews.com%2Fwalgreens-debuts-medicare-billing-solution-enable-cgm-access%3Ffbclid%3DIwAR135HFeohOyGhx5l2si_A4n7ze2figCULHztzbVaojaOiI68tO3SDGGrCM&h=AT3Eymkk7B5rFgT2wfkWaizxrYBksjmu5tnTvQ529jVF1rBthp0fKHSw9f8hSKXlrVk0qBVfLO_6HdkgD73CDnMqYuLNlwfa6kmBQcnRjMVpH0B-RROhj5SGGWaYugGElYY
Word of caution about AdaptHealth. I have a Dexcom G6 and I got prescriptions filled and sent by AdaptHealth. Every year I had endless problems with the yearly prescription renewal. AH would fax the wrong form to the doctor, claim they were waiting for more information and I would have to make multiple calls to AH, doctor and Medicare when AH claimed some other information was needed from the doctor. Eventually discovered through multiple calls to AH that: they faxed the forms to the wrong doctor office location; they sent the wrong form that did not request the “physician notes”; finally received the form and the prescription was “in processing”; never received the Dexcom supplies. My doctor office said they had another patient getting DME from AdaptHealth and they had similar problems for that patient. Now I get both my DME, including a Tandem t:slim, from Byrum Healthcare. No problems with the latest yearly renewal.
Well that is how Walgreens handled my order. In processing for days, trying to get me a receiver I didn’t need and saying they might need more from my doctor after she sent everything twice. Now, I had my account at Diabetes Management and supply for my Omnipods for years, so they always asked at every refill if I had seen my doctor and they made sure to send her all my papers to do whatever was required. In fact when they got merged into Adapt, I wasn’t sure who Adapt was.
The other day they got my Dex ordered in half an hour and sent my one month supply. The Solera division pharmacy filled my pods and got me a 90 day. So do I get this Dex paperwork all settled at six months? For the Dex renewal? Would Medicare fill a 90 day order for Dex? That’s the only hassle I see is ordering every 30 days for that. It was much easier when my local pharmacy handled my Dex!
Laura,
I get 90-day supplies for both my Dex and Tandem t:slim. I never got a 30-day supply. However a few years ago my Pharmacy only did 30-day of anything.
But all pharmacies can handle 90-day supplies these days. Since these “DME” are used continuously, a one month supply barely lasts long enough for delivery of the next one.
When Medicare made CGMs and pumps Durable Medical Equipment, pharmacies could not handle them directly. So the few distributors, such as AdaptHealth and Byrum , get all the business. If the Pharmacy takes the prescription, they have to get it delivered by those companies. And the DME suppliers keep getting consolidated into bugger companies.
All the paperwork for DMEs should be exchanged directly between the prescribing physician and the supplier. The patient should not have to deal with it. Unfortunately AdaptHealth was not good about handling that interaction after they acquired Solera.
Mark
Well we’ll see how the end of November/early December Dex order goes. I will try to get 90 days. The Adapt Pharmacy person was really nice and said my Omnipod 5’s will be sent in a 90 day order. She got it all done and they’ve shipped or will soon. It was fairly easy communicating with their DME and Pharmacy divisions, so just have to see how the next orders go.
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I’ve been getting my Omnipods from Diabetes Management and Supply (now Adapt and Solera) for years. Never had too many issues, except when they did the merger thing, they sent requests to my CDE and she didn’t know exactly who they were. Neither did I.
So they have been keeping track of my visits with her for years, plus andyy visit dates, prior auth or RX.
I have had one successful part B Sensor order from them with a transmitter. My next order they fulfilled a request and sent 90 days of sensors.
They transferred me to the pharmacy side and sent 90 days of Omnipod 5. The girl in the Solera pharmacy was an absolute delight. She was very helpful very informative.
The reminders showed up on the app. My only issue with it is it’s hard to get bad info off of it. Like it showed the old Omnipod order up for refill but I can’t use that old classic pod anymore.
I also got at least one email and one phone call asking if I needed anything.
The service has been better than in the past, and so far I’m pleased. I realize maybe in six months things might get bumpy but right now we’re doing good.
BTW the Community pharmacy told me it was their policy and Walgreens Medicare dept. that held my stuff up. I was called after I sent in a letter and filed a complaint online. The girl who called me claimed to be a manager but didn’t have the same name as the manager. So, I wasn’t too pleased. Glad I left.
True, as others have said, and also important to know, and also not obvious. They don’t seem to know it themselves unless you hit the right pharmacist.
I ran afoul of this when trying to get my pump insulin through Part B. It’s considered a component of the pump, therefore categorized as DME, and you end up with zero deductible if you do it this way. But Medicare can’t tell you how to do it (they barely recognize it as a thing), and pharmacists give you a pitying look (“No, hon, insulin is a pharmaceutical”). Somehow after a couple of, I dunno, MONTHS attempting to get it processed this way I stumbled on this whole Medicare Department thing and they were able to put it through. The Medicare administrator or whatever they’re called contacts the Doc to make sure you’ve been seen within 30 days (hate that) and that it’s for an insulin pump, and then they convey that information to Medicare, and then Medicare gives them a magic key with five glowing eyes and a strange radiating aura that the Medicare Manager vouchsafes unto the Pharmacist, who can then open the Sacred Sepulcher which issues forth the mysterious fluid, which in turn is solemnly delivered with all due ceremony and propitiatory sacrifices to the relevant gods, to the patient. And next refill, do it all over again.
Saves you 35 bucks though.
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I’ve got Extra Help Part D, so Im paying $10.35 for 90 days of pods and the same for my insulin. Solera handling pods and Kroger grocery pharmacy still handling my insulin.