What to expect at the Endo..

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Permalink Reply by Dave   _ on September 14, 2009 at 9:50am

First thing you need is an Rx. The doctor will handle the paperwork for the insurance. The insurance will review the request and MAY ask for additional documentation to bolster the claim that you "need" a pump. Good luck!

and there's no way to say how long it will take, perhaps from a week to a month, depending on how fast they "move". I once got a pump approved in a day, but other times, it took longer. One of my wife's pumps took us around a month because it was initially rejected, despite the fact she had 3 pumps before that time. crazy.

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Permalink Reply by Mike Shaw on September 14, 2009 at 8:38pm

Good luck at the endo. Hopefully you will get approved very quickly. It took me three days from the time the paperwork was filled out until my pump was shipped. I was really impressed with the the speed. I know of others that have waited for a month or more, as Dave said. It all depends on your insurance and the pump company. I had a phone call within two hours from the time I faxed the paperwork in to Medtronic verifying information.

One thing I can say is it will change your life from what you currently know as treating your diabetes.

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Permalink Reply by Christine on September 14, 2009 at 8:57pm

Thanks your postings are encouraging. I never thought I would be excited about pumping :)

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Permalink Reply by Mike Shaw on September 14, 2009 at 9:02pm

Me either Christine. I really felt like a little kid at Christmas the day my pump arrived. It has changed the way I deal with the D. I have much more flexibility than I ever thought possible. I don't have the CGMS and probably will not get that for awhile. But reading posts on this site, most are pretty happy they got it. Again, good luck. Kkeep us posted how it goes.

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Permalink Reply by Christine on September 15, 2009 at 1:44pm

update, referral for Endo is on the way. My representative from Insulet already emailed me order form and contact data for an insurance reimbursement specialist within insulet. Hope the Endo I'll see is pro Omnipod if not I will keep searching till I find one;)
Guess next step is to contact DexCom.

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Permalink Reply by Sarah on September 15, 2009 at 3:31pm

Yay.. good news :) Hopefully you can get in and be seen fairly quickly.. I've changed docs a LOT over the time I've been diabetic and it's always been a pretty long wait to get an appointment with a new Endo, but I never actually had a referral (never needed one with my insurance, but I'm sure it would have granted me some priority status in terms of scheduling).

I think in general, MOST endos who are pro pump really do not have a strong bias towards one or the other... it's about what you as the pump user would prefer.

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Permalink Reply by Christine on September 16, 2009 at 8:41pm

Got my referral today, that was fast! Call tomorrow for appointment.
As I understood now from Dexcom and Omnipod I fill out their request forms and bring them to the doc to sign and they do the work with the insurance company...

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Permalink Reply by Sarah on September 16, 2009 at 10:11pm

Assuming that your new Endo will sign off on it, yes, that's how it works :)

Your insurance however, may require proof that you've completed "diabetes education" before your pump approval though. It's usually not that big of a deal.. I had to do it because I had no proof of what I did 8 years ago... basically it required an extra visit with my CDE and with a dietician.

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Permalink Reply by Christine on September 17, 2009 at 12:32pm

Called today and got appointment for Oct 29...guess I get a big lab done before the visit and this gives me time to write the log..
@Sarah
I went through so many education classes I can't count...funny thing everyone tells you something else about what and what not to do...I have no records about classes of course but wouldn't mind doing another one. Since all my classes happened in germany anyway it may be interesting to see what they teach me here:)

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Permalink Reply by Dave   _ on September 17, 2009 at 1:53pm

I got my endo to forgo the requirement that I go to classes, which I would have had to pay for out of my own pocket. And I had NO PROBLEM starting on a pump, with very little assistance, other than the videos, manuals, and most importantly, a thorough understanding of John Walsh's Pumping Insulin book. THAT was the key to my success (well that, and my attention to detail :) )

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Permalink Reply by dargirl on November 3, 2009 at 2:45pm

Dave, does all insurance companies deny the pump classes. If I am a first time user that would concern me. You and your wife have been doing this for a while. For a newbie I would think the insurance would cover.

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Permalink Reply by Christine on November 3, 2009 at 10:31am

Just want to give an update...had my appointment last Thursday and Friday my paperwork for the Omnipod went out..now we have to wait and see..

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