I am using the Omnipod. Tricare covered my inital order. They denied my request for refill on my pods. I need to know what CPT code (billing code) your pump supplier uses to bill for your pump supplies/pods.

I have to figure out if Insulet (Omnipod) is using the wrong codes or if Tricare decided to change their mind on paying for the Pods.

I've been podding since May 08, not sure what's going on.

I am trying to put 2 and 2 together. If someone could answer this question for me I would really, really appreciate it.

Upset, Frustrated, T'd off

Cherise

Tags: billing, codes, cpt, insurance, pod

Views: 61

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I called Tricare codes that Omnipod tried to have auth isn't a covered benefit/non billable code
Cherise, call the insurance company. one time this worked "well you paid for it before" one time this worked "you will be hearing from my lawyer", one time, an appeal worked. If you get an idiot on the phone hang up and get another rep. good luck!
I also have Tricare (Prime) (The HMO version) and they paid for the pump and CGM HOWEVER I wanted to get a Omnipod and when the request was sent in Tricare actually changed it to the minimed pump, without any warning. It was quite a surprise but I was happy to get ANYTHING! I called and Tricare explained that Minimed is their "preferred" provider (whatever that means) and they only pay for minimed pumps and CGM! My suggestion is, call Tricare and find out if getting Omnipod supplies are a "issue". I'm having NO problems getting supplies approved, as long as their Minimed and from Minimed. Good luck!

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