one month ago Dexcom told me they were now "out of network" for my BCBS insurance for sensor reorders and referred me to "Diabetes Specialty Center" in Utah who has turned into a nightmare.. after telling me for the last two weeks they have "sent six requests" to my doctor and "called my doctor numerous times" but my doctor will not return the prescription form, I went to my doctor's office today to find that no one from Diabetes Specialty Center has faxed or called them at all.
so, even with my now daily calls to Diabetes Specialty Center (voicemails are not returned) getting no results, since I'm on my last sensor I need to forget Diabetes Specialty Center and find another BCBS In-Network provider who does very fast turnarounds to start over with. can anyone with BCBS insurance give me any suggestions? THANKS Biff
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Permalink Reply by type3mom on December 7, 2012 at 9:25pm We use Diabetes Specialty Center and have excellent service. I'm sorry you are having such trouble. I think you should call Dexcom and ask them for help. If there is another in-network provider for you, they'll know about it. Also, definitely tell them about the trouble you are having with DSC. Dexcom needs to know if a distributor is not providing good service.
Permalink Reply by Biff on December 7, 2012 at 9:34pm thank you, I will call Dexcom on Monday, but since their first referral hasn't worked out, I thought I'd people's personal recommendations. glad you had good luck with Diabetes Specialty Center.. I was initially very impressed by the polite DSC woman I am dealing with, especially since she wanted me to have her direct dial number, but at this point it's just ridiculous she's told these stories about having talked to my doctor's office when she's never contacted them, and you have to get her live on the phone because she will not return calls.
by the way, has Diabetes Specialty Center been supplying you with order status and tracking information? they told me once the order is placed they will not be able to supply tracking since they are "ordering through Dexcom" (which is what I want to keep doing BCBS!)
Permalink Reply by type3mom on December 8, 2012 at 7:27am No, we never get tracking info from them. That's the one thing I don't like about them. We were with Edgepark initially and I think they had better communication regarding shipments. However, we had such terrible billing issues with Edgepark that we called Dexcom asking for a different provider and they told us that DSC was in-network for us. They aren't really recommending one or the other, but they know which distributors are in-network for your insurance plan. I suspect that either of them can be good or bad depending on your luck. :(
Double check with Dexcom. They are in-network for Federal BCBS. Also, double check with your BCBS about Dexcom's status.
Best wishes
Permalink Reply by Biff on December 7, 2012 at 10:13pm thanks, Dexcom has always been in-network with my BCBS Anthem insurance, but when I called Dexcom to reorder sensors last month, Dexcom said BCBS in October had declared them out-of-network. I even called back someone else at Dexcom to double check and was told the same thing. but you are correct, I should ask again (and again). I've leanred it's often helpful to ask the same question to a number of different people to see if you get a variety of answers. thanks.
Permalink Reply by Biggrob on December 7, 2012 at 10:23pm I have also had excellent service from Diabetes Specialty Center in Utah, They have practically gone out of their way to make sure I have sensors and time them perfectly so my insurance covered them 100%.
Permalink Reply by Carolyn A. on December 8, 2012 at 5:04am I have bcbs and get everything from Edgepark. You can order your supplies on line with them, or have an auto shipment set up.
Permalink Reply by HPNpilot on December 8, 2012 at 6:03am I have Anthem BCBS in NY... I can't get fulfilled via Dexcom directly for sensors, but have to go through Edgepark. Interestingly, the sensors are sometimes shipped directly from Dexcom, but billed via Edgepark!
Permalink Reply by Biff on December 9, 2012 at 5:07pm isn't that amazing?? Diabetes Specialty Center also said they will "order through Dexcom" (and not be able to supply any order or tracking information because of that). I don't know whether BCBS dropped Dexcom like Dexcom says, or whether Dexcom is now refusing to accept what BCBS wants to pay them, but it does seem odd how anyone, Dexcom, BCBS, or especially I will benefit from an additional third party being thrown into the mix.
Permalink Reply by Phil Lindner on December 8, 2012 at 6:09am This may or may not seem obvious but have you considered appealing your BCBS decision regarding Dexcom being out of network? Many people don't know or forget this option even exists. I have used it several times for different things and have won every time.
Case in point, I started using Dexcom shortly after the System Seven came out (before the Seven Plus). At that time Dexcom was considered out of network for CareFirst BCBS of Maryland. I appealed the decision in writing per CareFirst's instructions. I explained the Dexcom would help to improve my diabetes control and would potentially reduce the chances of diabetic complications and higher medical costs in the future.
You could also explain your BCBS plan's referral to "Diabetes Specialty Care" and all the problems you have had with them. Be very specific with your details.
I won by appeal many years ago and all my Dexcom equipment and supplies are covered.
Good luck!
Permalink Reply by JD on December 8, 2012 at 6:25am
Permalink Reply by Biff on December 9, 2012 at 5:17pm thanks for your information.. this sounds so much like the runaround Diabetes Specialty Center has given me over the last three weeks. what I cannot accept is the untrue things they have told me about having sent the presciption they need "six times" to my doctor and "we've talked to them countless times." I knew that was untrue since I've been with my doctor for over 15 years and his office has always without exception faxed back prescrptions within a couple hours at most, so it was no surprise when I went to my doctor's office and learned no one from DSC had ever contacted them even once.
tomorrow morning I might call Diabetes Management & Supplies, and if they are BCBS in-network see if they can get my order handled in a day or two (and send tracking information) like I've heard people say. since Diabetes Specialty Center has wasted three weeks of my time, I'm now on my last sensor, and I'm so dependent on these Dexcom sensors that I'd be afraid to go to sleep or leave the house not wearing one.
Manny Hernandez(Co-Founder, Editor, has LADA)
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