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Charging for CGM download?

Discussion in 'Parents of Children with Type 1' started by nebby3, Aug 18, 2014.

  1. nebby3

    nebby3 Approved members

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    We just got a bill from our endo's office (Joslin in Boston btw) and it includes $50 for reading the CGM results. Anybody ever heard of this? I'm not sure if I can bypass this by downloading it myself and bringing in the results or not. Kind of peeved right now.
     
  2. dianas

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    Yes, it's been a separate billable code as long as cgms has existed as far as I'm aware. My docs have always charged for this in addition to the office visit and I've been to a couple different endo practices in the area and as far as I know all the docs charge for it unless they forget. Doesn't matter if you download at home, if you want your endo to look at the downloads they can bill for it.
     
  3. Nancy in VA

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    I bring in our CGMS download, and the Endo looks at it, but still uses the pump download as the "authority" as far as making recommended changes - that said, they are often consistent. I'm surprised there is an extra charge, though.
     
  4. sszyszkiewicz

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    Are you talking a blinded CGM, where data are collected for a week (you cannot see), or are you talking about your Dex?

    if the latter....sheesh. $50 to read Dex data and provide advice? Really? Did they charge to read your fingerstick data on some random piece of paper or spreadsheet? I am relatively new to this T1D world. I was imagining the T1D medical professionals would like once a week take a look at my kids data and be some sort of coach/advisor. They would provide some practical advice, and at the same time teach the parent/child up to the point where they would need less and less advice. Man did i get myself unused to that idea fast enough. They only want to hear from us in emergencies and when we go in for our quarterly checkups. They also make sure our prescriptions are filled. We are literally one of hundreds they are responsible for. I am thankful for that but really this has been a teach em to swim by throwing them in the water kind of experience.

    So we swim.

    At our last appointment the NP couldn't be bothered to even download our receiver or look at any of the reports. I knew ahead of time they didnt have the software so I brought my laptop and was eager to share but they were uninterested. We have since asked for a new nurse practitioner so hopefully that will work out.
     
  5. mamattorney

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    That's ludicrous. I could see using that diagnostic code outside of a regular appointment if you wanted a pow wow about numbers and adjustments and it couldn't be considered a "visit", but to tack on $50 to read cgm data for a regular appointment? I'd be livid if I paid anything other than a flat copay for a visit.

    ETA: I just checked the last three EOB's and thankfully, our endo did not charge for this. Just two codes - Medical Visit and labwork. Thank goodness
     
    Last edited: Aug 18, 2014
  6. KatieSue

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    Ours won't even download the CGM or look at the data at all just the meter. Which is annoying.

    $50 seems steep though to just hook it up and download it.
     
  7. Beach bum

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    We are in the study, so we haven't seen a charge yet (come Feb will will). Is the $50 charge above and beyond the usual cost of a clinic visit, or is it just broken down to show services used? I'd call billing and ask them to explain. When you download there, do you do it in the lobby, or in the clinic? I wonder if it makes any difference.

    IMO, you should have been told up front that yes they do look at CGM readings, but it is an additional charge to do it. I also think that if the endo/nurse ask for the data to get an even closer look that a)they should not charge b)be up front about the charge.
     
  8. missmakaliasmomma

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    That's ridiculous... We have an appt the end of this month so you bet I'm going to ask if the endo does it too
     
  9. nebby3

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    The $50 is in addition to the regular visit charge. They download it in the office. I did ask billing about it and he said it was a charge to interpret the CGM data. I didn't ask more at the time to know if it would make a difference if I download it myself. We have lost both the endo and the CDE we loved recently and I am really not feeling like we get much out if visits. To be charged an extra $50 because we now have the Dex really peeves me. And because we have a high deductible we haven't reached I am paying the $50.
     
  10. Sarah Maddie's Mom

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    I agree. It's insane.
     
  11. Beach bum

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    That's insane.
    IMO, what difference is it than interpreting a meter graph or a pump print out? It's just another tool. I would challenge the charge because you were not told up front about the CM download fee...

    FYI, saw the beloved nurse and docs (don't know if you used Dr. R or Dr. M)recently at camp and they are all doing well!
     
  12. Megnyc

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    I believe that my endo bills for reading the CGM download but my insurance covers it (I just have a flat copay for specialist visits). I guess I don't really blame him. Including whatever he gets for the CGM reading he only gets paid around $170 (including my $30 copay) for a 30+ minute visit. That doesn't seem like very much to me.....

    ETA: Even though I understand the reasoning behind the charge I agree that you should have been told about it if you don't just have a flat copay.
     
  13. jenm999

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    Roberta, we just had our first visit with a new endo at MGH and not only does she not charge for the Dex interpretation, she was more than happy to use the printout I had brought. Did not look at fingerstick numbers, wanted trends and ballpark ranges (I was shocked when our previous CDE wanted the numbers out of our meter rather than looking at the crystal clear Dex readings!). She is also willing to set up an appointment for our son's grandparents, teachers, babysitters, anyone involved in his care to help them learn about T1. We have only met one CDE so far but he is great and my son really likes him. First pump appointment tomorrow! PM me if you are considering a switch and want more info.
     
  14. nebby3

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    We had been seeing Dr. R for 8 years or so. We had our CDE since diagnosus almost 11 years ago. Change is hard.

    Jen-- I am going to PM you.

    After talking to Joslin twice and our insurance company once, I am giving up and paying the bill. We have a really high deductible we have only come halfway to meeting so not much is covered. The doctor's visit was billed at $440, down to $271 after insurance discounts and then the $50 is on top of that.(I will say for our insurance though that we have had to pay nothing for Dex and its sensors etc so it is probably worth it for that.)

    I am thinking of:
    a) only going 3 times a year
    b) switiching clinics all together
    c) not bringing our Dexcom to our next appointment or just refusing to let them download it so I don't have to pay an extra $50 for what is usually useless advice
     
  15. caspi

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    Personally I would just bring the charts and reports with you and tell them you are not going to pay to have the Dex downloaded. If they don't want to look at what you brought them without charging you a fee, I would seriously consider a different endo. I think it's utterly ridiculous that they are charging to look at medical information during your regularly scheduled visit.
     
  16. MomofSweetOne

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    A friend told me that they were charged $200 for it. She said it had only two weeks of data on it.
     
  17. Ali

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    Agree insane. It is actually easier to read a CGMS graph and data than a meter. The download breaks it all down. My Endo still just looks at the last few weeks of the CGMS data and looks to see if anything huge pops out at her on the trends and numbers and then maybe has a suggestion. Identical to meter but really easier to read for everyone. Ali
     

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