Tricare. Omnipod.= Issues

I am a relaxed, goofy, free spirited person. When you mess with my family or my health there’s an issue–a huge issue.

Here’s my issue:

Febuary 9, 2009 I called Insulet to re-order my pods. I knew Insulet runs a little slow in processing re-fills, not sure why. I was told by a CSR, my referral would be submitted.

I called back a couple of days later, talked to the same rep. She said everything was processed, it takes up to 72 hours for approval.

A few days later I received a e-mail from Tricare about my authorization request. Yeppie, I can re order my supplies. I logged on to Tricares website. The request read *Non-Approved*. WTH, why would they deny supplies to a pump they approved? I was a little confused and upset.

Monday, I called the supervisor at Insulet. I explained the pod’s had been denied. She said they have issues with Tricare paying for the Omnipod system.
She wasn’t sure why. She said she would call Tricare. The Supervisor from Insulet called me back, the CPT codes they use for the POD’s are considered investigational and will not be paid for.
At this point my blood is boiling.
I called Tricare with the Super from Insulet. I was told the codes from the Omnipod weren’t correct. The Tricare rep told me, the codes was for a whole new insulin system. The Super and I explained I already had the pump, just needed the supplies. The Tricare rep said she would make a note on the auth, request is for supplies only not the pump.

I hung up with Tricare and The Omnipod Super.

3 days later I called the Omnipod Super. She said she would talk to the billing dept Super to see if there are different codes. I haven’t heard from the the Supervisor from Insulet.

To Be Continued….

Be Blessed
Cherise
Iphone-blog

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About Cherise

Diabetes (Type 1.5/LADA) has been living with me for about 4 years. I am using the Omnipod insulin delivery system and I love it. I am not going to say I don't have a bad pod every once in a while because it does happen. I am a wife, mother and I work full time. Thank you for stopping by please feel free to browse and leave a comment! View all posts by Cherise

8 responses to “Tricare. Omnipod.= Issues

  • Tony Rose

    I guess that answers some of my questions about the OmniPod. It looks pretty neat, but it seems to be a hassle. I guess the only real benefit of the pods is that there is no tubing. Which, don’t get me wrong, it a pretty cool benefit.

    The insurance issues are ridiculous. It should be between the company and insurance company to work out and not you have to call every other day to get them moving. Keep us posted.

  • George

    One thing that I know, is that you will get this taken care of. The question is, how many heads are gonna have to roll? You. Go. Girl.

  • Karen

    It makes my blood boil when one of us had to jump through hoops just to get the supplies we need to live. Really boil. Ggggrrrrr.

  • Jolie

    So sorry to hear you are still having trouble getting this taken care of. I just don’t understand how they could approve the pump, but NOT the supplies. Hoping everything works out the way you want it too…and SOON!

  • Cherise

    It’s terrible but I’m a fighter. I am not going to give up. I trying to figure out the best way to handle it. If it’s meant to be it’ll be but I’m going to fight it. I will keep you all updated. Watch out Tricare cause here I come…

  • Catherine Thompson

    I know right there is nothing more aggrivating than trying to deal with an insurance company any insurance company for that matter . I cannot stand them and when I get off the phone I feel like I have not accomplished anything . I am sort of glad I dont have insurance right now but I can just see the fights coming when I do get employment again if i ever do with this economy and everyone laying everyone off . good luck dear and hope you resolve this issue soon .

  • Chris

    I heard the Onmipod is now being approved under TRICARE with the A4222 code for supplies. Insulet took our refill order.

    • Cherise

      I haven’t updated my blog in a while:( I did get my pod’s and happy that tricare and insulet worked out the billing issues.

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