Saturday, January 14, 2012

Pump Process


I knew starting out it would be a bit of a journey to getting started in the pump process, however it seems that it's even more tricky of one than I expected. We took the necessary courses, carbohydrate counting in August, and Pre-Pump Classes in Dec. Now mind you back in December the educator made it sound like the process would be a breeze and I quote her.

"You will submit for your pump, they'll ship the pump to your house, you'll get educated on site, changes, pump functions, and get started on saline, a week later you will come back in and go live on insulin".

Hmm sounds pretty good. However here we are 1 month and 2 weeks later, and we are still no further along really then where we were in December. We decided to go with the Medtronic Minimed and was told the process to getting approved through our insurance usually takes up to 30 days. Well look now it's well over 30 days and where are we?

The information for the pump was finally submitted, and is in the works of being processed, reviewed and pending approval through the insurance company, which now we're basically waiting another 30 days... Oh and where do we stand with the CGM you might ask??? A certain insurance claim handling lady from Children's is attempting to make the decision that it is a waste of time trying to get the CGM approved through Clifford's Insurance.... She is basically refusing to do her job and submit the needed paperwork, which by the way is only 2 documents, probably a total of 5 to 10 minutes of her precious (has a working pancreas) time. I like to throw that last little bit in there because she still has a working pancreas, and all I'm asking is for a chance to make my son's (non working pancreas) life a little easier. So 5 to 10 minutes out of her time to do her job is not asking that much. So in speaking with Clifford's case manager through the insurance company it seems they actually get this wait for it, approved a cgm ... Wait what back the train up because said insurance claims lady stated they NEVER approve them. Whoops looks like she was wrong. So now the case manager is going straight to the doctor to get the necessary paperwork that needs signed so we can start the process for the approval of the cgm. I don't see us getting it anytime soon, but I do see us getting it eventually. I also see said insurance claims lady getting a talking to one way or another for not doing her job.


On a positive note I've included the picture at the top of what Clifford's new $7K pancreas will look like, isn't it pretty!