You may have seen them on TV, these small sensors that diabetics can wear on their arms rather than having to poke our fingers 3-4 times a day to check our blood sugars. They are called continuous glucose monitors (CGM) and I want one.
To be clear, it’s not just because all the cool diabetics have them (I’m looking at you, CS). It’s also because along with the 3-4 finger sticks a day, I also inject myself in the stomach another 3-4 times a day with insulin, and for my kidney surgery I will also be injecting heparin 2x a day.
So along with a belly covered with polka-dot bruises in shades of red, blue, and yellow, I also typically have purple polka dots along my fingers. Which is so much fun when you are typing. Also, with the blood thinners, I’m a constant biohazard if I think I’ve stopped bleeding but haven’t.
My endocrinologist and I are agreed that switching to a sensor is ideal for a number of reasons (including being able to track sugar spikes and dips on a 24/7 basis) and she submitted an RX to the pharmacy.
And thus the paper chase began. First Walgreen’s filled the prescription, but it was showing up with a co-pay (I’m max out of pocket, so I don’t have any co-pays right now). I spoke with the pharmacist and they said they would re-try and get back to me. Of course, they are busy, so they didn’t. So I tried to chat with my insurance (United Healthcare) to find out what they were supposed to do. They explained that because the sensor is not a medication, but a piece of equipment, it had to be submitted to the medical insurance rather than through my prescription plan. He suggested they re-run it and it should be fine.
So I called Walgreen’s and told them what the insurance had said, but surprise – the tech couldn’t get it to go through. She said she would call back later, which she didn’t, so I called the next day and spoke with the manager who confessed there was no way for them to run it through medical – they just weren’t set up to do that.
Back I go to UHC and they now tell me that the only way to have it billed to medical insurance is to go through one of their two selected providers, which the previous rep forgot to mention. I try the first provider, Byram Healthcare, and after 25 minutes all that has happened is that I was transferred 5 times. So I hang up and try the second provider, Edgepark Medical Supplies. This time, after navigating a fairly straightforward menu system, I get a live agent and we work through everything. It still takes 20 minutes, but I hang up feeling like we are finally on our way.
Not so, fair reader. I get an email 2 days later inviting me to set up an online account, and since I’m all about online, I eagerly click the activation button.
Enter your date of birth, the website requests.
I type in my birthday and click enter.
Wrong birth date entered. Please try again.
I type in the date of birth more carefully, but still it is rejected.
Wrong birth date entered. Please try again.
I start re-considering my mere existence. Have a forgotten when I was born? I was very little on that day, so I can only trust that my mother told me the truth and that it is not some vast right-wing conspiracy.
However, confident that I was indeed born on the date I had entered, I call Edgepark once again. The wait is slightly longer this time, but the agent on the phone explains that my birth date had been entered incorrectly. She assures me it has been updated in the system and we hang up the phone.
I hang up and try to activate the online account again.
Wrong birth date entered. Please try again.
Sighing, I enter in the incorrect birth date, and am immediately activated. Fortunately, I’m able to log in to the profile section and update my information to reflect my actual birthday. And then I notice that they also have my last name spelled incorrectly. This, of course, is not a field that I can edit.
I call the Edgepark agent again, and hold a little longer again, but finally she is able to correct my name and when I hit refresh on the website, the change has indeed taken place. I see where my order is just pending insurance verification, and feel confident that now that my information is accurate, it should go through.
Alas, fair reader, if only it was true. Instead, I woke up to a notification that the order had been cancelled, and that I needed to call them back. I speak with another agent and am told that I was not approved because I have Type II diabetes, and my policy only covers Type I diabetes for a CGM.
More than frustrated, I call UHC once again. I speak with a kind man who assures me that I am indeed covered for this device, but I just need a prior authorization from my physician. Again, would have been helpful to know the first time around.
So I then contacted my endocrinologist once again, asked her to call the prior authorization line and let them know I’m approved for it and it is urgent, and then once I get confirmation this has been received, get to reach out to Edgepark again and try again.
I would cross my fingers – but they have bruises! So think good thoughts!
Good luck!!!