Insurance now require more info for CGM coverage

[ecs1516]

I just got a call today from Edgepark that they are requiring two new forms from the doctor because of insurance. This is to get more sensors. They ask like how many times you test a day and last lab results etc.
We have been using the Navigator since August. United has been paying already for the system and several boxes of sensors. This seems silly.
Anyone else having to get endo to fill out more detailed forms??:confused:

[moco89]

Yep. It delayed my shipment of sensors, mostly because my doctor's office is incompetent, though.

I have UHC, and they pulled this off on me. I suggest that you order the sensors asap to avoid this problem.

[ecs1516]

I ordered them a week early thank goodness because I wasn't made aware of this earlier. Do you get your supplies thru Edgepark too?

[moco89]

Yep, but UHC has the same policies for everyone using cgms.

They will only authorize X amount of boxes at a time.....

[Ruthellen]

I have been struggling for weeks with Edgepark with the Sensors. Last time I ordered Sensors they sent them right away - this time I am calling daily and getting nowhere with them. No one at Edgepark is keeping me updated - we can go days without anything happening.

Who else is a supplier of the Navigator sensors? My insurance urged me today to use a different supplier since this is typical per Edgepark.

[moco89]

Try Smiths medical.

They're the distributor for the Deltec Cozmo.

[ecs1516]

Our United insurance didn't have a contract with them for the sensors back in August. Not sure if they ever worked it out. We get our Cozmo from them.
Just got an email my sensors shipped yesterday from Edgepark. Will have them Friday!:D My endo got in the forms and the lab notes.

[ecs1516]

Ruthellen, who are you talking to at Edgepark? Are they telling you need the new forms?
There has been several people contacting me with updates there.
Ruthellen, who is your insurance through?
I hate the thought of me switching to another supplier then I've got to fill out new forms again!!

[Ruthellen]

Wow! What a day with Edgepark.

THey started the day telling me that they had my paperwork and were faxing it over to insurance momentarily (CareFirst - part of BCBS of Md).
Then 4 hours later I was told that they didnt have any of the paperwork from my doctor (The Edgepark rep did tell me she saw it yesterday but does not have it now so we need to start all over again). Unbelievable. Our wonderful CDE faxed it again and then they told me it would take 2 weeks to get prior auth from insurance.
Meanwhile I started calling supervisors and finally found the right people to talk to - they did some faxing back and forth and within 30 minutes they were packaging up my sensors to overnight them.
I guess I should have started complaining weeks ago.
Phew!
I will have to go through this again in January - maybe then I'll switch providers (or now I have phone numbers of supervisers that can help me....)

[ecs1516]

Ruthellen, What supervisors helped you? Your insurance company?
Glad you are getting your sensors. I've been down that road before too.