Welcome to Diabetes Forums!
You are currently viewing our boards as a guest which gives you limited access to view most discussions and access our other features. By joining our free community you will have access to post topics, communicate privately with other members (PM), respond to polls, upload content and access many other special features.
Registration is fast, simple and absolutely free so please, join our community today!
If you have any problems with the registration process or your account login, please contact contact us.
|  | | 
10-08-2009, 10:57 AM
|  | Senior Member | | Join Date: Jul 2006
Posts: 603
| | | Just got home from Endo appointment... And I was ready to strangle his PA! I told her I needed a prescription for strips. She asked me how many times I test...which also irritates me since they give me a form to fill out before I go in asking questions like how many times a day do you test.. I tell her 10 times +/- a day. She says "I don't think insurance is going to pay for that many." I told her that they have been paying for that many all along. She tells me that they're really cracking down and that she's getting a lot of requests to justify testing. At this point I start to feel my BP rise! I said again "they've been paying for 300 a month". She said "I know, but that doesn't mean anything. They don't want to pay for that many strips". Now my face is turning red and I'm gritting my teeth trying to keep from screaming at her! I finally said, with great restraint, "look, just basic testing requires 7/8 tests a day. Then there's driving, dealing with lows and highs, snacks, not to mention the error readings. Trust me, I'm using them to test, not selling them on Ebay!!! She says "I know, I don't think you're selling them, its just insurance is cutting back on the amount of strips they'll allow. I'll try, we'll see what happens." Ummm, HELLO?! Why is it she is so sure they're not going to pay for the strips that they've been paying for all along??? GRRR!
Just needed to vent. <sigh>
__________________
Katherine
type 1 (1.5) 12 years, Pumper 6 1/2 years? or so.
| 
10-08-2009, 11:04 AM
| | Senior Member
I am a: Type 1.5 | | Join Date: Feb 2009 Location: KCMO
Posts: 5,429
| | | Are they keeping stats on the script writers? I MEAN ...
Does she win a free cruise if she writes the least? (rolleyes). I feel like asking them that.
__________________
Linda Initial A1c Feb 6 09: 12% Aug 24 A1c (MD office) 5.5%
Jul ... C-pep 1.3, GAD-65 > 30 metformin 1000 mg BID
Simvastatin 80 mg
Ramipril 5 mg
T4 125 mcg
baby aspirin
Vitamin D3, 2000 IU (blood values normal, advised to continue this dose by endo)
CoQ10 100 mg
Eating 70 - 90 g carb per day
Interval training on recumbent cycle
BMI is down to ca. 25.8 According to Joslin's Diabetes, 2005 ed., 5 - 30% of those diagnosed as Type 2 actually have LADA. | 
10-08-2009, 12:01 PM
| | Senior Member
I am a: Type 1 | | Join Date: Mar 2008 Location: Cambridge, MA
Posts: 544
| | | I got the exact same thing when I went to my endo a couple weeks ago (new endo). The PA did write the prescription for the # of strips I wanted, and the script was filled w/out issue. Hope I don't get krap when I try to refill them...it's stupid that this issue even comes up, for any of us.
__________________
Gretchen MM 522 pump (blue) since May 2007 (RIP Becky (07/25/09), long live new blue Becky II)
CGMS-ing since November 2007
DXd April 1993 @ 30 years of age, Type 1
A1Cs: 7.4 (12/07); 6.6 (03/08); 6.0 (06/08); 5.8 (10/08); 5.8 (02/09); 5.7 (07/09) "I slit the sheet, the sheet I slit, and on the slitted sheet I sit." - Navin R. Johnson, The Jerk | 
10-08-2009, 12:04 PM
|  | Senior Member | | Join Date: Jul 2006
Posts: 603
| | Quote:
Originally Posted by foxl Are they keeping stats on the script writers? I MEAN ...
Does she win a free cruise if she writes the least? (rolleyes). I feel like asking them that. | I should call and see if she's on vacation next week, maybe she's winning the contest! 
__________________
Katherine
type 1 (1.5) 12 years, Pumper 6 1/2 years? or so.
| 
10-08-2009, 12:07 PM
|  | Senior Member
I am a: Type 2 | | Join Date: Sep 2008 Location: Las Vegas
Posts: 782
| | | Ya know, that really irritates me. I'm guessing about 90% of T2's that docs see are semi-compliant to non-compliant. When they get somebody that is adamant about testing so they can be in complete control, they should cater to those needs.
__________________ "That which doesn't kill us makes us stronger" - Friedrich Nietzsche | 
10-08-2009, 12:12 PM
|  | Senior Member | | Join Date: Jul 2006
Posts: 603
| | Quote:
Originally Posted by GretchO I got the exact same thing when I went to my endo a couple weeks ago (new endo). The PA did write the prescription for the # of strips I wanted, and the script was filled w/out issue. Hope I don't get krap when I try to refill them...it's stupid that this issue even comes up, for any of us. | I'm getting ready to take mine to have it filled, we shall see. I doubt there will be an issue. What is so frustrating about it is that the last time I was there we had this same conversation. At the time she was filling out forms for me to get my Ping. How many times to test was on the form. One of the things that really tick me off her even having to ask me how many times I test...they should have that on file, right? Not to mention that stupid form they have me fill out every time I go that asks HOW MANY TIMES DO YOU TEST?! Why fill that stupid thing out if you're not going to look at it?! Anyhoo...I didn't need strips at that point but had to call when I got my Ping to switch from Freestyle to the Onetouch strips. AND SOBE (son of a biscuit eater  ) if they didn't call it in as "test 5 times a day".  I swear I'm about two seconds from finding another endo...or just going to my GP.
Sorry...more ranting, it just fell out. 
__________________
Katherine
type 1 (1.5) 12 years, Pumper 6 1/2 years? or so.
| 
10-08-2009, 12:27 PM
| | Senior Member
I am a: Type 1 | | Join Date: Mar 2008 Location: Cambridge, MA
Posts: 544
| | | For me, getting c-rap from the pharmacy tech was what made me wanna scream. I do mail order now, but needed to do an interim prescription until the mail order thing when through and they shipped them out. The pharmacy tech kind of snorted and asked "You're really going to test that many times?" I was sooooooo PO'd I wanted to whack her. When I was over being dumbfounded and could speak again, I told her I was pretty sure it was none of her business. Do other patients get this much c-rap at every turn?
__________________
Gretchen MM 522 pump (blue) since May 2007 (RIP Becky (07/25/09), long live new blue Becky II)
CGMS-ing since November 2007
DXd April 1993 @ 30 years of age, Type 1
A1Cs: 7.4 (12/07); 6.6 (03/08); 6.0 (06/08); 5.8 (10/08); 5.8 (02/09); 5.7 (07/09) "I slit the sheet, the sheet I slit, and on the slitted sheet I sit." - Navin R. Johnson, The Jerk | 
10-08-2009, 01:43 PM
|  | Senior Member | | Join Date: Jul 2006
Posts: 603
| | | GRRR!!!!! I just got home from CVS. I dropped off my prescription, ran an errand and when I got back to pick it up they tell me that my insurance is saying its too soon, I have to wait until the 15th. The reason being, the old OneTouch script!!! It was that "test 5 times a day". I told them that the prescription was different, test 10 times. She said that they would call the insurance company. I call CVS to see if its straightened out and I'm told that my insurance company has to approve the change with the supervisor! SOBE! Sometimes I just want to freakin give up. Isn't dealing with this disease itself is quite enough all by itself. The stress of dealing with doctors, pharmacies, insurance companies...I wonder sometimes if its worth it.
__________________
Katherine
type 1 (1.5) 12 years, Pumper 6 1/2 years? or so.
| 
10-09-2009, 04:37 PM
|  | Senior Member | | Join Date: Jul 2006
Posts: 603
| | | Well, it only took a day and a half, but I FINALLY got my test strips! GEEZ! I thought after talking to someone this morning that they were going to try and force me into using the "preferred" brand, Freestyle. Our insurance policy doesn't have a tiered plan, its either generic or brand name, so was confused by the pharmacist talking about Freestyle being the "preferred" brand. I thought I was going to end up not just fighting to get my strips, but the brand too! I'm just relieved, all worked up over "nothing" I guess.
__________________
Katherine
type 1 (1.5) 12 years, Pumper 6 1/2 years? or so.
| 
10-11-2009, 03:17 PM
| | Junior Member
I am a: Type 2 | | Join Date: Apr 2006 Location: Toronto, Ontario
Posts: 47
| | | Gosh I feel for you. I am in Canada and we do not have any of those irritations (yet) but I feel they're coming. | 
10-11-2009, 03:48 PM
|  | Senior Member
I am a: Type 1 | | Join Date: Aug 2007 Location: UK
Posts: 877
| | | I think you should take your bg logs along and ask her which tests you don't "need". I would love to hear her justifications and reasons on which ones where not needed. If she even tries to make a few suggestions ask what would have happened if it all went horribly wrong, if you ended up in A&E would she sign a piece of paper saying she would pick up the bill? | 
10-11-2009, 06:14 PM
|  | Senior Member
I am a: Type 2 | | Join Date: Aug 2009 Location: Richmond, VA
Posts: 653
| | | This brings a question to mind -- I talked to my insurance company before going to the doc earlier this month. The insurance company covers 200 strips per month. I told the doc this, he said I shouldn't need that many, but wrote the prescription for the 200 anyway.
The PHARMACIST asked me how often I tested because she didn't think that I needed 200 a month, and because the insurance company didn't like paying for that many.
I ended up telling her that I usually test 3-4 times a day, but there are days when I need more. They only filled me for 100 of the 200 that the doc wrote.
That's 100 for 25 days, which is 4x a day. I would get all up in arms about it, and I half way still feel like I should, but I actually DO usually only test 4x a day -- it's more than that on weekends though.
100 aren't going to last me 25 days, I don't think. I guess I'll talk to the pharmacist next time.
__________________
-Jeremy
8/13/09 (Dx) A1c: 9.5 FBG: 320
10/12/09 Avg BG: 104 Avg FBG: 96
Metformin XR 500mg once daily
Low(ish) Carber @ < ~60g-75g per day Comin' along! | 
10-11-2009, 06:27 PM
|  | Senior Member
I am a: Type 2 | | Join Date: Jul 2009 Location: Atlanta, GA
Posts: 794
| | | Jeremy, I would have been furious! If the insurance company has said they will cover 200 a month, and the doctor has given you a prescription for them, then it's none of the pharmacist's business. Period. I would have made them go ahead and fill it as written, and then if there was a problem when they processed it I would have addressed it then.
I just don't understand why so many people are having problems getting the strips they need when their insurance policy says they cover them. It's mind boggling.
__________________ Metformin 2000 mg
7/24 a1c=9.3
10/23 a1c=6.4
Diagnosed 7/22/09
Weight loss as of 10/23/09: 25 pounds!  | 
10-11-2009, 07:21 PM
| | Member
I am a: Type 1 | | Join Date: May 2009 Location: TX
Posts: 488
| | Ha.. and here my CDE asked me on Thursday "are you sure 300 is enough? I can write it for more if you want me to" after I mentioned that my RX was going to run out before I saw my Endo again in two weeks, and I said 300 was just fine since that's all insurance will cover without a pre-auth, and I really wasn't sure I wanted to go through the hassle when I didn't have a problem with what I was getting
She did mention that insurance HAS to pay for however many strips are prescribed if it says on the RX to test before driving, especially for anyone who is hypo-unaware (and yes, I always test before getting in the car). I didn't think to ask how many more per day she would suggest, since I seem to do fine with 10X a day.. some days are less, some more, but overall, it seems to work out.
Sorry you had to deal with bean counters, but I'm glad you got your strips in the end 
__________________
Sarah, T1 since 2000 PINGing Apidra along with Dexcom 7+
| 
10-11-2009, 11:25 PM
|  | Senior Member | | Join Date: Jul 2006
Posts: 603
| | Quote:
Originally Posted by shiftzor I think you should take your bg logs along and ask her which tests you don't "need". I would love to hear her justifications and reasons on which ones where not needed. If she even tries to make a few suggestions ask what would have happened if it all went horribly wrong, if you ended up in A&E would she sign a piece of paper saying she would pick up the bill? | I don't know what the deal is with this woman, but I've just about decided to look for another endo. She's NOT the endo, haven't seen him in so long I don't think I could pick him out of a line up with two to chose from! I guess since I'm in control they don't see a reason to waste his time. I left this last appointment not only upset about the strips but she also cut the appointment short when a nurse came to the door. I don't know what the deal was, the nurse didn't say anything, must have mouthed something to the PA. She said she would be right back. A while later the nurse came back in and asked me if I needed to talk to her about anything else. I was still fuming about the strips ordeal and then flabbergasted when the nurse, and not the PA, came back to the room. I just said I needed prescriptions, which the nurse had in her hand, and left wondering why I drove 45 minutes in rush hour traffic. I completely forgot to ask about Apidra and whether she had got a request for Orbit 90's. <sigh> And then I had to deal with the pharmacy/insurance fiasco.  Yeah, the nerves are still raw.
__________________
Katherine
type 1 (1.5) 12 years, Pumper 6 1/2 years? or so.
|  | | | Thread Tools | | | | Display Modes | Linear Mode |
Posting Rules
| You may not post new threads You may not post replies You may not post attachments You may not edit your posts HTML code is Off | | | |  | | » Site Navigation | | Diabetesforums.com | | | !-- gallery --> Resource Directory | | | !-- soon --> Contact Zone | | | |