Wednesday, June 29, 2016

Diabetes Mysteries: Kelly And The Mystery Of The Missing Test-Strips

When I was in first grade I started reading the Encycledpedia Brown mystery books and loved them.  
In third grade I stumbled upon my older sisters Nancy Drew and Cherry Ames, Student Nurse mystery books and loved reading them and trying to figure out who the bad guy(s) were. 
I never got into the Hardy Boys books, but I will admit to watching the TV show because SHAUN CASSIDY. 
Solving mysteries was fun as a kid. 

As an adult, solving  diabetes supply mysteries takes up way to much time and it's bullshit. 
Yeah, I don't have time for this for this shit.
I placed my three month supply order of test strips last week with EdgePark

Cut to Monday when I received an automated message from EdgePark letting me know order had shipped. GREAT and good to know. 
Late yesterday morning I received another automated message from EdgePark telling me that my order had been received and should be shipping in one to two business days. 
OK, that's WEIRD and dare I say...mysterious?  
Maybe Edgepark filled my RX twice - which would mean massive amounts of crap with my insurance. 
I called EdgePark, waited on hold for 18 minutes and 37 seconds until I was connected to  a woman who told me that I did indeed have two orders shipping out.
Again, WEIRD.  
So I cancelled the second order and as I was about to hang up, the woman on the other end of the line stated: You’ll receive your 12 boxes of test strips tomorrow - have a nice day! CLICK. 
Here’s the thing: 12 boxes was half of my three month order - I normally get 24 boxes (down from 27,) and 200 strips a month won’t cut it. 

I thought (OK, PRAYED,) that she made mistake or that I heard her wrong and I called right back, waited another twenty minutes on hold before speaking with another EdgePark CR who told me that: 
  1. CareCentrix had cut my order (RX) in half
  2. the reason I had two orders out was because they were going to try and bill CareCentrix and my insurance twice. 
BIG MYSTERY - not solved, but uncovered.  
First: Why wasn’t I informed my order was cut in half? 
Second: Why didn’t anyone tell me the reason behind the double order in the first place?? 
Three: What if CareCentrix/my insurance, wouldn’t pay for the second order, which was the order I had just cancelled? 

The CR couldn’t tell me why the order was cut in half and informed me that they would have done their best to get paid for the second order that I had just cancelled 30 minutes earlier.
Me: OK, but nobody told me that my Rx had been cut on half and what if my insurance wouldn’t pay for the second and now cancelled order? 
EdgePark: Well...... we would have done our best to get the money.
Me: Would you have charged me the full amount if I hadn’t cancelled the order and my insurance wouldn’t pay? 
EdgePark: Ahhhhhh. probably not? 
YES, her response sounded more like a question than an answer.
ME: Yeah, I need my full order of strips - how can I make that happen? 
EdgePark: Call your Dr’s office and have them resend the script to CareCentrix.

So that’s what I did, and then I called CareCentrix. 
I had a direct line and name of someone at CareCentrix because I’d an issue with EdgePark and my test strip order in December. 

YES, I know this story is long - please stay with me,folks~
I called my contact, and who, according to her voicemail was out of the office for a week, but who and left a name and number of her counterpart - a woman I shall call G. 
G who was very nice and understanding when I called and explained the situation - and she was a bit perplexed. 
She told me that she would work to get the remainder of my strips approved and promised to follow up with me - which she did. Calling me yesterday afternoon to let me know she’d called my Endo’s office and was working diligently to get the problem solved. She was a former nurse and she new the importance of checking blood sugars. 

And I also had a message from R, a manager over at EdgePark who promised he would call me back on Wednesday (as in today,) and that’s exactly what he did. 
R apologized for the test strip issue and told me that the reason my order had been cut in half was because my RX from December had expired. But that edgepark had received a new Rx on Tuesday and sent out the rest of my strips to me by Friday.

ME: Thank you for calling me back, R - I really do appreciate it, but that can’t be right. My RX was dated 12/27/15 and I placed my order last week.
So, even though I didn't have my order refilled in March because a friend of mine had switched strip brands and had given me her 3 month supply of Onetouch strips, and I had explained that very fact last week when I placed my order and was told it wasn't a problem . 
And even if my Rx technically expired in 6 months from the date it was written, ( my Endo normally writes them for year, but ok, I could be wrong)  my prescription refill would have still been good through Monday, June 27th, which was two days ago, and well after my original order was placed. 
Also, that's not what your CR rep told me yesterday.


R was a good egg and was trying to help rectify the situation and I appreciate his hustle and follow up,  but nobody - not EdgePark or CareCentrix can tell me why my original Rx was denied in the first place. The Rx I’ve been getting for years. 

G from CareCentrix called me back today to tell me she received the Rx from my Dr's office and would work to approve the additional strips. 

Then I told her what R had told me. 
And I also stated that every single time I need to get a DM order filled, it's never seamless, wether has to do with pump supplies or test strip supplies, because there are three companies involved when it comes to filling out my durable medical equipment prescriptions. 
Having to deal with my insurance company, CareCentrix, and EdgePark in order to get a prescription filled, means nothing is automatic or efficient, and always requires countless phone calls and extra time.
Nobody is on the same page and whenever there's a problem, which is a lot - I get three different answers - and none of them are correct. 

How is any of this efficient for everyone involved? 

G told me that she wants to work with me, and together we could look into different mail order options for me. 
And I will  - but right now - I want to close the book on this chapter because I have to much shit to do. 

So while the test strip Rx mystery isn’t solved, my problem is... for now. Lets see what happens in September and December.


Sarah Spiller said...

This reminds me of every time I have to get any CGM supplies. I have to call Neighborhood Diabetes and wait two weeks for them to maybe ship it out for me, with no shipping notification or anything. Upgrading/ getting replacement supplies is a whole other story though. I called Dexcom because I got a low battery alarm for my transmitter a few weeks ago and I asked if I could upgrade to a G5, since I've had my G4 with Share for over a year and my transmitter expired. I called on a Sunday about my transmitter, so I was told to call back on Monday to speak to a customer service rep. I called and they said I was eligible to upgrade, so I was transferred over to Liberty Medical (which recently bought Neighborhood Diabetes) and they had to check again to see if I was eligible to upgrade and I had to confirm my info with them. I was told that they notify me when they shipped my new CGM and CGM sites. A day later they called to inform me that they needed insurance information, so I had to call them back and tell them that (even though my insurance and Liberty supposedly work with each other) and they also informed that they have to call my endocrinologist to confirm my prescription. They haven't emailed me with a shipping notification or called back to update me; so now I'm stuck in limbo with a dead transmitter, while waiting for a new Dexcom that I thought I was going to be getting last week. You've got to love how everyone "works together!"

Rick Phillips said...

It is like I say all the time. I have a job and it is not to sit in my chair talking to you. Ok technically I do not have a job except what Sheryl tells me to do,, ahh yeah I guess I do have a job,,, nevermind.

I referred your blog to the blog page for the week of June 27, 2016.

Brian said...

Would your insurance company possibly be Cigna?

I have the same issues with CareCentrix and Edgepark. Right now everything is smooth, but wait till the next reorder.

Funny thing is that none of the insurance documents I get from my company or from Cigna ever mention CareCentrix or Edgepark. I sure hope Cigna saves money on this process, for the hours I've spent on hold...