Animas is now Limiting Sets and Cartridges
OK, this is huge and I want everyone to help fight this now.
I was approved by my insurance for the usual five boxes of sets and cartridges.
I called the supplier to find out why that had gone down to exactly three for 90 days. She said I was approved for five boxes.
The lady conferenced me in to an Animas rep.
His name is Chris.
He told me Animas has been audited by the governement and sets can no longer be issued in large quantities.
You can no longer, according to him, order too many boxes of sets or cartridges.
Apparently five is too many. My order, and I have not ordered for six months, was changed to three.
You can get a special deal from your doctor if you need it, but otherwise no they are limiting orders.
He stated Animas will be shut down if they do not comply.
I stated three boxes per month is not sufficient to cover supplies if you need spares.
The Carecentrix representative told me and get this:
The reason you have a trainer come out and give you pump training is so you wont have any bad sets.
Animas said "If you have a bad set, we want it sent back for examination."
I said what about your cat eating the tubing? What about hitting muscle and destroying sets? What about air bubbles and tossing sets for that? There are many instances when people need more sets. The Animas agent Chris admitted that was true, the Carecentrix rep said no that isnt true. She kept referring to that is why you get trained, so you dont ruin sets. I asked her if she had ever lived with sets and been limited in the number. She said yes. I doubt it.
I was treated rudely by her not Anims necessarily , I was told I wasnt listening and treated like I did not know what I was talking about.
You can see a discussion I had yesterday, where this has happened to at least one other member of this group.
I was told by the supplier I needed to talk to her patient advocate because of my not listening and my behavior. Finally they let me talk and I told them a whole country full of diabetic pumpers who use Animas, will not be happy with this. If this is the new rule, I hope all of you will get out and make phone calls.
Btw, my local reps reaction was oh, thanks for telling me what you are dealing with. That is it. Mind you yesterday an insurance person from Animas wrote me an Email and told me my doctor had made the change in amounts, not Animas.
I am literally shaking. I cant believe it, and even more so I cannot believe Carecentrix would treat me like I dont know what I am doing.
To even suggest that training from the pump company prevents bad sets, is beyond me. Truly beyond me. I will most likely never qualfiy for financial assistance now, because these people are so rude to me. And I dont trust Animas anymore, because no one was straight with me from there either.
I was approved by my insurance for the usual five boxes of sets and cartridges.
I called the supplier to find out why that had gone down to exactly three for 90 days. She said I was approved for five boxes.
The lady conferenced me in to an Animas rep.
His name is Chris.
He told me Animas has been audited by the governement and sets can no longer be issued in large quantities.
You can no longer, according to him, order too many boxes of sets or cartridges.
Apparently five is too many. My order, and I have not ordered for six months, was changed to three.
You can get a special deal from your doctor if you need it, but otherwise no they are limiting orders.
He stated Animas will be shut down if they do not comply.
I stated three boxes per month is not sufficient to cover supplies if you need spares.
The Carecentrix representative told me and get this:
The reason you have a trainer come out and give you pump training is so you wont have any bad sets.
Animas said "If you have a bad set, we want it sent back for examination."
I said what about your cat eating the tubing? What about hitting muscle and destroying sets? What about air bubbles and tossing sets for that? There are many instances when people need more sets. The Animas agent Chris admitted that was true, the Carecentrix rep said no that isnt true. She kept referring to that is why you get trained, so you dont ruin sets. I asked her if she had ever lived with sets and been limited in the number. She said yes. I doubt it.
I was treated rudely by her not Anims necessarily , I was told I wasnt listening and treated like I did not know what I was talking about.
You can see a discussion I had yesterday, where this has happened to at least one other member of this group.
I was told by the supplier I needed to talk to her patient advocate because of my not listening and my behavior. Finally they let me talk and I told them a whole country full of diabetic pumpers who use Animas, will not be happy with this. If this is the new rule, I hope all of you will get out and make phone calls.
Btw, my local reps reaction was oh, thanks for telling me what you are dealing with. That is it. Mind you yesterday an insurance person from Animas wrote me an Email and told me my doctor had made the change in amounts, not Animas.
I am literally shaking. I cant believe it, and even more so I cannot believe Carecentrix would treat me like I dont know what I am doing.
To even suggest that training from the pump company prevents bad sets, is beyond me. Truly beyond me. I will most likely never qualfiy for financial assistance now, because these people are so rude to me. And I dont trust Animas anymore, because no one was straight with me from there either.
Replies to This Discussion
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Permalink Reply by Laura S. on
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But, how is the government (or whoever) getting in and clamping down on what they ship out?
Apparently they wont ship above three boxes?
Unless you jump hoops and get your doctor to state you change either every three days or two days then wont budge. -
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Permalink Reply by Cheri on -
I have to change every 3rd day due to skin irritation. It wasn't a hoop - my doc simply indicated that.
And, I don't literally always have to change every 3rd, sometimes it is 4 - so, like GW, I have learned to save and stash.
I'm starting to be confused about what exactly the problem is. You must coordinate with your doctor, the insurance, the go-between, and Animas. Sad, but true. No way around it, you have to manage it or it will manage you. -
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Permalink Reply by Cheri on
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The purpose of the go-between, by the way, is to ultimately conserve and save money for the insurance company (which, I am convinced, is how they make their $$) - so you have to fight for your rights.
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Permalink Reply by solo79 on -
See that's where I don't get what they told you because I do get 4 boxes even though I run out before the end of 90 days even though my insurance has approved 5 boxes every 90 days. Speaking of time to change out. LOL and to call to reorder. let the reorder fun begin.....
Accidents do happen, yes sometimes it is user error, especially when you are new, like I was. or something happens... Yes I have to watch the kitties too... LOL but sometimes it may be that you do a rotation to a spot your not used to and pop there it is in your hand, on the floor or wherever.... Even yes pulling it off accidentally when you are undoing the tape or needle cover. In which I have figured out how to rethread the inserter to not lose the set, since they only ship me under enough for the 90 days. -
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Permalink Reply by MossDog on -
I would bet that this stems from Medicare. Medicare basically states if our rules state x then how can you be more generous to people without insurance or with different insurance? If you do it is considered fraud. If the person needs more than the Medicare determined x then their Doc needs to state so and fill out some paperwork attesting to your need. The government comes in a say "Why does Laura S. get 5 boxes when Medicare guidlines allow only 3 boxes. She must go through the rigamarole of getting the paperwork that states she needs 5 boxes every three months"........
I do not know that the above is what happened but I see these types of things with other DM supplies and also DM education billing. I do not think Animas cares one whit what you order. Like I said yesterday I would think they have a vested interest in you ordering and consuming more of their product so I can't think of a legitimate reason for them wanting you to decrease your supply. I do think Carecentrix was totally out of line and you should raise a fuss there and complain for the way you were treated.
I would ask Animas to forward your doc a Certificate of Medical Necessity in which the prescribed change frequency of every 2 days and make sure you stress this. If it reads every 2-3 it gives them the freedom to choose 2 or 3 or in the middle if they so choose. -
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Permalink Reply by Cheri on
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Ah - you may be right. I did not get that Laura was on Medicare - I know (or have heard) that they have some patient-unfriendly rules and regs.
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I'm not old enough to be on Medicare.......thankfully, no.
I got my authorization paper in the mail today, it said five boxes.
Animas called my doctor, they said send her five boxes.
And it is supposed to be that way every single order.
Animas for some odd reason came up with three, told me I needed authorization for more and I had that the entire time.
It could be that the government or someone is clamping down on excess orders, but my order was totally and fully approved and should never have been reduced down for any reason. -
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Permalink Reply by Tom Gohl on -
Laura-
All I can say is that I feel your pain! My Animas IR-1200 is on the shelf and I'm unhooked because of repeatedly dealing with infusion site malfunctions, unpredicatability, inexplicable high-BG readings and just general stress and frustration. I've been off the pump for 9 months now and could not be happier back on Lantus, the "poor-man's pump".
My initial reason for unhooking was that I accidentally stripped the threads off the battery cap on my 4-yr old IR-1200 just before a 10-day business trip. Had no spare, and my doctor, pharmacy, and insurance company all cooperated beautifully to get me set up with a "temporary" supply of Lantus for basal insulin. I am so happy to be free of all the unpredictability of infusion sites, tangled tubing, pump malfunctions.
I know Lantus just does not do the job for many folks, but for me, it is just a huge improvement. My A1-C is better. I've learned to adjust for days of heavy activity, including 100-mile days on a bicycle and a half-marathon or two.
Like you, I rarely had an infusion set work flawlessly for more than 48 hours. Frankly, finding a BG at 280+ is not my idea of good feedback for knowing that something's gone wrong. I experienced those multiple times per week while on the pump and my poor wife had to hear me cuss and shout through every one of them! On Lantus, I've not had a reading over 200 in 9 months that did not have a good explanation. The mystery factor has dropped by a couple of orders of magnitude!
Enough of this I suppose.
Best of luck to you. I'm no doctor, but Lantus rocks for me!
-Tom Gohl -
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Thank you Tom. I wish I could be more successful on MDI.
I may find out one day soon.
I appreciate your reply and am so glad you are doing so very well. -
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Pick or choose the answer you like:
a. The doctor changed your prescription to three boxes. He did not.
b. The government will shut us down if we do not comply and send less. Really? according to another pump company rep, no they are not involved. Maybe someday but no, not now.
c. Your Health Care Plan has to authorize five boxes (or whatever). They did. -
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Permalink Reply by MossDog on
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I know Animas is JCAHO accredited. I do not believe Medtronic is (I could be wrong on this). Perhaps this is the difference between what another pump company rep said vs this one? I don't know Laura. I am trying to make sense of what you have been told. As you can tell I am an excellent conspiracy theorist :-)
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I am waiting for a nurse to call regarding Carecentrix and their shameful behavior.
Apparently Animas called my doctor and his office confirmed five boxes should be sent.
Three different answers from three Animas reps.
And as you can see here, people receiving less amounts than normal and the same as normal.
And I dont even abuse the system by over-ordering. -
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