Recently I called Medtronic to place my infusion set and my test strip order. I have already received my infusion sets but not the test strips. So I called Medtronic to ask about the status of my order. The person I spoke with said that 'they' were waiting on chart notes from my doctor. This afternoon a veteran RN from my doctor's office called to ask "why do you test 10-15 times a day when Medicare clearly says you only need to test 3 times a day since you are on insulin"? She added "I've been a nurse for 35 years and never heard of anyone testing that many times a day".
She also said that because there are no indications of DKA (which I've never had) or other serious complications in my chart - that there is no need for me to have a pump either. I've had a pump for over 5 years and now she is going to make sure I get it taken away from me just because I'm trying hard to stay complication free? I'm scared.
I will never understand how an insurance company or any of their medical staff have any idea what is and is not a good thing to do with MY diabetes. I have had this discussion with my insurance complany before and it actually took my doctor to call them and explain it. In this case it seems your own doctor is the one against you.
This always baffles me. Do they think a good A1C just happens by itself? Why the penny pinching on strips, I would suggest there is a high correlation between high strip use and less complications, thus strips are an excellent investment for the insurer.
Perhaps your doc can help straighten this out. Otherwise perhaps it's time for a new doc.
I'm sorry you have to go through this and hope you can get it resolved quickly and successfully.
If I were you I'd switch doctors. This office and their RNs sounds dangerous to your health.
Don't be afraid to 'interview' doctors either. Ask them outright when you are considering them....how do you feel on pumps? how do you feel on testing and how often it should happen? etc.
You need to advocate for yourself by partnering with a doctor and their staff who will ALSO advocate for you!
I went through something similar...switched doctors, and never looked back.
I had a physicians assistant once tell me (when I was on MDI) I only needed to test once a day. Right. I would find the doctor who ordered you the pump (whether they are there or elsewhere) and let them know this is unacceptable. I would also ask for a supervisor or liason or something.
Completely agree with Kari. I'd have a conversation with your current doc and tell them that you feel strongly about this and if they can't support you then you'll find a doctor who will. Then interview new docs leading with asking if they will support you in the type of care you believe is keeping you healthy.
I'm sorry you have to go through this but don't be afraid to speak up for what you know you need. There are docs out there who agree with us and cannot understand why insurance isn't willing to pay for the small things to keep you healthy but they'll have to pay later if you aren't healthy. Keep your head up and keep pushing.
are you a type 1 or type 2 diabetic? who did the original Rx for your pump and the prior Rx for 10 - 15 times a day test strips, who put on you insulin? If you have type 1 and are insulin dependent, any insurance company will pay for additional strips, the doc just needs to pre-auth it and send it to the pharmacy or whomever - wherever you get your test strips refill from? If you are a type 2, the pump and additional strips are not covered. if you're a type 1 diabetic, tell this nurse she doesn't know what she's talking about~! and ask to speak to the doctor.
Who sent the info (medical necessity info) into Medtronic to get your pump?
I am type 1 diabetic since 2003. My c-peptide was 0.1 the last time it was tested. The Doctor who diagnosed me has moved to another state. The nurse at my GPs office that I spoke with today was trying to get me to PROVE that I tested that many times a day. I offered to bring my pump in so they could download the information from it, but she said "I'm looking for evidence of complications or else Medicare will not pay for anymore than 3 test strips per day." So I suppose because I've worked really hard to avoid being hospitalized with DKA or low blood sugar - then she is not going to cooperate with me.
well, you've been getting your test strips the 10 - 15/day Rx from somewhere within the last 5 years, since your original doc moved to another state. from whom did you get those strips from? that's simply not true, one doesn't need to have 'complications' to get additional test strips, I don't know any type 1 who only tests 3x's a day..maybe type 2's. we test a lot not only to avoid hyper but HYPO blood sugars, where have you been getting your supplies from? do you go to an endo, who's been following you and downloading your pump, Rx'ing your insulin. don't you download your data and provide that to your doctor?
I get my test strips from Medtronics for the last 16 months. I don't go to an Endo, my GP writes the Rx for my insulin.
I used to see an Endo but quit going to him because: at my last appointment when they took my pump to be downloaded, someone messed up my settings and returned the pump and tubing to me with insulin just dripping to beat heck from the tubing. The Endo viewed the download and then told me that I was trying too hard to lower my A1C - that it didn't need to be lower than 7.5. After that statement he left the room to see his next patient - leaving my personal medical chart on the computer screen for anyone to see.
I waited until the nurse came to tidy up the room for another patient and asked her kindly to please close the computer screen as I didn't think my personal information was anyone else's business. I will not see that Endo again unless forced to do so.
i guess i'm a bit confused, someone had to send info to medtronic to get your test strips. If medicare has been paying for those 10+ test strips/day over the past 16 months, what's the problem? maybe because it's a new year and you need new prescriptions. just say you've been getting the same prescription for the past 16 months and medicare has INDEED been paying them. Unless you've just recently, beginning of this year, changed to medicare? If you see a GP for your type 1, then he/she would have downloads and meter results, confirming you test that much. Make an appointment to go see the GP and discuss.
I tried to explain to the GPs nurse that called me today that Medicare has been paying for them along with my secondary insurance for the past 16 months. I've been on Medicare since 7-1-2010. The nurse insisted that since my chart didn't contain evidence of DKA, other complications like amputation, neuropathy, hypo unawareness - Medicare would most certainly not have paid for more than 3 strips per day. There was just no reasoning with this nurse.
well, she's wrong. make an appointment with your GP - in person, you said medtronic needs records that you test...do you follow with this GP, does he/she know you're on a pump? Just my opinion, but I would suggest making an appointment with an Endo.
I felt the same way, almost said that.."well, I'll call her." Frickin telling a type 1 diabetic he/she only should test 3 x's per day...makes me so angry too. It's probably a nurse who has NO clue about type 1, etc...
This nurse sounds like an idiot. Medtronic might be able to help you fight this in the interim, but you need to find another practice.
Ask the nurse how she thinks you achieve such a wonderful a1c. And then ask her if she would like to be held liable if and when you kill someone
or yourself because you drove a car without knowing you were low because you didn’t have
enough test strips.
Sounds like she needs her nursing license revoked.
About 6 months ago I happened to call the GPs office to renew my prescription for test strips. She said and I quote "what is a test strip used for"?
This is the kind of ignorance that seems to prevail in these days. It is almost like she thinks I expect her to pay out of pocket for my test strips and I don't. I do pay out of pocket for my Dexcom because I have hypo unawareness. Two nights ago I was sitting at my computer and got up to let my dog go outside. As I stood and walked toward the door I felt slightly dizzy - tested my blood sugar and I was 39 (2.1). I had no warning whatever. Try and prove that I had that happen to me to this nurse??
She was looking for major complications like DKA or a hospitalization which I have not had.
then, take charge, you probably should be seeing an endo anyway..that would have been my red flag right there. you said they wanted/need testing, hypo data, well, you have your meter/dexcom and pump which would indicate a low right there.
and, maybe that's the reason why your first endo didn't want you to try for such a low A1C, if you're hypo unaware...! works both ways, ya know. Those Endos are liable, responsible, basically if they've Rx'd the pump and we're not managing our blood sugars in a cautious and healthy way. if you're hypo unaware..maybe you do need to let your sugars go higher for a bit. also, i re-read your post..can't imagine a nurse telling a type 1 they're going to take their pump away...?????
