Pump supplier problems

Has anyone ever had this happen before? I am switching from omnipod 5 back to tandem because my husband and i are trying to have another baby and with tandem i had better control. i didn’t plan on upgrading my pump to tandem mobi but was told i had to because they do not make t slim x2 anymore. When i was answering the questions for ccs to submit my order to the insurance company they asked me how many supplies i have on hand and i said i wasn’t sure because i was in my car-maybe 30 days and they decided then that they wouldn’t send my order, the rep accused me of trying to commit insurance fraud and said he could go to jail for submitting my order (which i thought was very unprofessional). I called another time and tried to talk to another rep about the situation and she argued with me that omnipod is a pump and agreed with the previous rep that i am trying to commit fraud. I haven’t been on an actual pump or ordered pump supplies in two years and i get my omnipods monthly. Also i was told when i started with omnipod that its a pharmacy benefit not DME-this was confirmed with my insurance company today (i called them too and they said the mobi pump is 100% covered no problem).

I guess my question is could ccs report me to my insurance or anything if i try to order from another company?? I canceled my order with them and am starting a new one with the company i get my dexcoms from but i’m worried about them causing problems for me with my insurance. I was really upset by how rude and out of line they were when i’m just trying to do my best. I’m absolutely not trying to do anything illegal. Also does anyone recommend any other places to order the mobi from if my supplier doesn’t have it? Thanks!

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I get pods from Part D at Solera pharmacy division and when they ask, I throw out a random number and they fill my order. In fact they fill it without any questions as long as my CDE has the correct notes on file. This is dumb and rude. You should be able to have pods or go through and get a regular pump.
Iknow people who have done this very thing with no issues. Blessings!

You might start by calling Tandem. The pump companies have a way of getting their devices into people’s hands, despite all the roadblocks. I would just call as if I were a brand new customer who wanted to change pumps.

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The question about supplies comes from Medicare requiring DME suppliers to verify on hand quantities for refill orders. Many DME companies make their reps use a script that asks all the questions regardless of what your insurance requires. Here’s the thing that really gets me about your story. None of the reps said to you "I’m asking how many days supply of the Tandem X2 supplies do you have?’ Also the lying about the X2 being discontinued. Some other users reported the same shenanigans going on with CCS and the Dexcom G6/G7. The X2 came out in late 2016 so in the next year or three we are going to hear about an end of sale date but Tandem should (has to?) keep supplies available through the end of warranty date of the last pump sold.

Your insurance company only cares that the DME company isn’t overbilling. There are other DME companies, I’ve got a list somewhere of companies that sell Dexcom, most also sell pump supplies but there are no good suppliers, just a little less bad ones.

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My understanding is that the Medicare limit is 10. My answer to how many days supply I have remaining is “about 10” and that has always been an acceptable answer.

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In Ashley’s case the answer is 0 or “new pump, who dis?”

I took a look, the last revision to the pump LCD says place an order within 30 days, supplier can’t ship until delivery would occur with 10 days remaining. Since @ashleyx1356 said “about 30 days” everything about CCS’s handling of her order is wrong. Asking for a manager might have gotten a pump and supplies shipped.

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I would try to use anyone but CCS, unfortunately many if not all of the DME’s have terrible reputations.

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I had a pretty good distributor out of Iowa - Homelink medical. They were a living nightmare the first few years I worked with them, but then they were bought out and the new version of them was fantastic - highly reliable.

They were actually the only ones who identified the problem with the billing codes related to the Omnipod 5 upgrade that was breaking all industry computer systems everywhere. They stopped distributing Omnipod 5, but I spoke with a diabetic on their end who was going to great lengths to explain the hang up to insurers and pharmacies all over the Midwest. She was phenomenal.

I was a little alarmed by the comment ashleyx1356 made about the T:slim X2 going out of production. I found this on the Tandem web site:

It obviously shows other “older” T:slim models. I don’t think this includes the X2.

With regard to CCS med, I have been using them for 2 years since I switched from Medtronic to Tandem’s T:slim. CCS are a little disconnected. I looked at going to the omnipod from a Medtronic 770G which the warrantee had expired. The ominpod is only available through pharmacy insurance. Medicare would not cover it through Durable Medical Equipment. I ended up with T:slim X2. CCS med told me it was covered and the changed to it was not covered 2 cycles back and forth. We finally arrived at the T:slim X2.

Medicare are perspicuity about the number of supplies left. I always tell CCSmed less I have less than 10 on reordering as bkh had suggested. Are they afraid we will sell surplus supplies on eBay?

Maybe I shouldn’t have brought up the medicare excuse. I don’t know what insurance Ashley has but since the goal is to have a child chances are it isn’t medicare.

Picking a DME company is a lot like picking a rapid acting insulin. Many people can use anything. Some people are allergic to the antics of one company but can tolerate the hanky-panky and high jinks at another.

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  1. Call your medical ins. co and see what their rules are regarding pumps (which ones are covered); when they allow reordering. See if they have preferred DME suppliers (usually will cost less). Research any new supplier before trying them.
  2. I used CCS briefly - they were the antithesis of customer service.
  3. I found that small companies provided the best service but they often get bought by the big ones and service goes into the toilet.
    I currently use Bedard Medical Supplies in Maine and they are wonderful. 888-233-2737
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