I Hate Supply Companies!

My title is not exactly a fair statement because not all supply companies are bad.  When you are ordering supplies that you need to either keep you alive or keep you healthy, it is a little frustrating that a supply company won’t ship you something, even if that shipment is within the terms of what your insurance company allows.

This started for me in July when it was time for CCS Medical to ship my Dexcom sensors.  For those of you using the Dexcom, you know that there are four sensors in each box.  I was sent three boxes so I had a total of 12 sensors for my 90 day supply.  I haven’t been one of the lucky ones that have been able to extend the life of sensors.  In fact, my first sensor died on day 6.  I did not call Dexcom and ask for a replacement because it was so close to the end of its “official” lifespan anyway.  CCS Medical shipped my Dexcom and three boxes of sensors on April 21st.  I received and started using the Dexcom on Friday, April 23rd.  If you are actually changing sensors on day seven like they are approved for, those 12 sensors last a total of 84 days.  I would have pulled my last sensor out on July 16th.  I had two sensors that Dexcom did replace during that period so I had a couple extra days added in there.

When I got the reorder card from CCS Medical, it said that the ship date was July 21.  Technically, at 90 days they should have shipped them on July 19th.  Because I had a few extra days in there, I was not concerned that they would not ship until the 21st.  July 21st was a Wednesday and I did not receive them until almost 6:30 PM on Monday, July 26.  I actually called CCS on Friday when it was obvious they were not showing up to verify if they had been shipped or not.  I ran out of sensors over the weekend and called them again on Monday. 

I have been ordering my test strips from a different supply company since I started with my insurance plan in December, 2007.  They also send a 90 day supply of test strips.  I am allowed to call them 7 days before the 90 days is up to order more strips.  I always have those strips before day 90 hits and I have never had to worry about running out.  I actually have a little spreadsheet setup in Excel so I can figure out when my 90 days is up and know when I am allowed to place my order for supplies.  When I called CCS about them not shipping my sensors until day 92 and it took another five days to get them, they told me that my insurance company would not allow them to ship them before 90 days was up.  I knew that was not true because the supply company I get my strips from ships them right before 90 days is up and they get their invoices paid without a problem. 

I then called my insurance company and explained to her that the approved usage time for the sensors was 7 days and technically, I was getting an 84 day supply.  When I told her that CCS said that was the insurance company’s policy that they were not allowed to ship them out, she told me what I expected her to say – that was not their policy.  I figured that I would wait until it was time to reorder sensors again before I get into that with CCS.

When I got my pump, Animas sent my paperwork to CCS to process that.  CCS shipped my pump on June 11th.  Like most new pumpers, I had some issues with supplies in the beginning and messed up a bunch of sets.  They originally shipped enough for site changes every three days.  I went thru half of what they sent me for 90 days in the first two weeks I had the pump.  They sent my doctor paperwork to change the site changes to every two days.  I was still going to be short, so they again sent my doctor paperwork so I could change my sites every day and a half.  I am also having problems with my Apidra breaking down at about 43-45 hours and I am actually changing my stuff out every day and a half.  Like the sets, I messed up a couple cartridges in the beginning.  I am not filling the cartridges up so that I don’t waste so much insulin and I have run out of insulin a couple times and had to change out the cartridge even earlier.   When you go to your pharmacy and get 30 pills, unless you accidentally drop one on the floor, those 30 pills will last you 30 days.  Pump supplies don’t work like that.  If you have a bad site, you take the set off.  If you have a bad day and need more insulin than normal, your cartridge will run out and you replace it. 

CCS Medical never sent the reorder card for my supplies.  My 90 days hit on September 8th.  I called them yesterday, the 7th, because I will be out of cartridges by next week.  I have enough infusion sets because when I requested a sample of the Orbits, they sent me two boxes of those.  I like the Orbits and ICU Medical is working with my pharmacy for me to be able to get those from them.   CCS Medical does not carry the Orbits – that surprised me that a supply company the size of CCS would not want to carry the infusion sets that everyone seems to be raving about on message boards.  I first read about the Orbits on TuDiabetes and most people that tried them seem to really like them so I requested a sample. 

I still need to get cartridges for my pump.  I called CCS and was told they go from the 11th to the 11th not an actual 90-day count.  The bill they sent my insurance said it was a 90 day supply, not a 93 day supply.  The 11th falls on Saturday and I was told that I could call on Monday to place my order.  Because CCS uses a calendar day as opposed to actually looking at 90 days and my calendar day falls on the weekend, I was told that I could “order” my supplies on day 95! 

I again called my insurance company and asked the same question I asked in July.  I was told that they were allowed to ship them so that I had them by day 90, otherwise, I would run out. 

I called CCS Medical back and talked to another person.  When he tried to blame my insurance, I let him know that I talked to my insurance and that is not their policy.  Then he tried to say that if they were going to ship them before the 11th, they would need another slip from my doctor!  They billed my insurance for 90 days worth of supplies so I should be able to order my supplies on day 90 without getting another slip from my doctor – that is just insane to think otherwise.  Another problem they had was the person that got the approval for site changes every day and a half did not put that piece of paper in my record.  The person I spoke with yesterday said all they had was the approval for every two days.  When I called him, I had pulled the packing slips that I had and told him to do the math for what I was shipped – they obviously had approval to give me enough supplies for every day and a half. 

He said that he would talk to his supervisor and call me back.  When he called me back, his supervisor would not budge either – even though my 90 days was technically up on the 8th and if they actually shipped them on the 8th, I would not run out.  If I have to wait until the 13th to order, I will run out.  One of the posters on the ADA message board had a similar problem with CCS and she wrote a letter to her insurance company.  She had been told the same thing by CCS that I was – it was her insurance company’s policy.  She also found out the same thing that I did – it was not her insurance company’s policy. 

I told him that I am not willing to run out of pump supplies every three months because CCS Medical has a policy that they will not ship supplies in time.  I told him that I will get my supplies from someone else and that includes my Dexcom sensors.  I have never worried about running out of test strips and even if I actually ran out, I could run into any pharmacy and buy a box to hold me until my supplies showed up – I can’t do that with pump supplies.  Because CCS Medical ships anywhere from 92-95 days instead of day 90, I would have to go back to MDI every three months until my supplies show up. 

The good news is that because I liked the Orbit Micros so much, I had given ICU Medical my insurance information to find a supplier for me.  I had not heard anything so I called them.  They had given my name to a supplier who was supposed to contact me.  During the conversation, he mentioned Mom & Pop suppliers.  For the heck of it, I brought up my insulin pharmacy.  I had just switched to them in June when I got my pump because I had to get insulin used in a pump from a DME supplier.  It is a pharmacy about 15 miles from where I live.  The day I picked up my first order, the pharmacist asked me about getting my strips from them.  I had just received a 90 day supply so I told him that I did not have a problem switching to them when it was time to order again.  I gave ICU Medical the name & number of my pharmacy.  I also called the pharmacy because I needed to talk to them about placing my first my strip order with them.   The pharmacy was interested in getting the Orbits for me.  ICU Medical sent me out another box of the Orbit Micros to hold me until my pharmacy can get their account set up. 

The pharmacy called me this morning to let me know it might be next week until they get the Orbits because of having to submit a contract to ICU Medical.  I told her that is OK because they sent me another box and I should have those by Friday.  I have emailed the guy at ICU Medical several times and yesterday, he said that he would also be able to get my pharmacy set up with a distributor so that they would be able to get my Animas cartridges for me.  I am going tomorrow to pick up my test strips so I am going to drop off the information about the cartridges.  I gave her the part number for which Orbits I wanted. 

CCS billed and was paid by my insurance company $600 a box for my Dexcom sensors from April.  In July, they billed my insurance company $775 a box – I am still waiting to see what my insurance ends up paying for those.  Depending on what my insurance pays for the last three boxes of Dexcom sensors, CCS Medical lost $7,200 – $9,300 a year in Dexcom sensors alone by losing my account.  I had actually called them about getting my pump insulin thru them but they were not set up to bill for that yet – I am extremely grateful that I did not order insulin from them and being sent a 90 day supply of insulin that doesn’t ship again until day 95!
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