Updates

So, I have to say that the past couple of weeks have been, well......long. My son was diagnosed with a sinus infection and then last Friday, I strongly encouraged my husband to go to the doctor because he sounded awful, too. He also was diagnosed with a sinus infection and given a 3 day supply of an antibiotic that stays in the system for 10 days. That sounds good! Well, he took the meds and by Monday, he was completely confused/disoriented. We went back to the doc and he was dehydrated! Turns out he's having a reaction to the antibiotics and we'll have a few more "confused" days while the meds are making their way out of his system. Poor thing. This really has nailed him. I want spring and good health for all!!

OMNIPOD UPDATE: Ok, so I'm down to my last box of pods and knew I had to call. Remember, Omnipod was supposed to call me with an update on the GreatWest dilemma and they didn't. So, I called up and talked to a very nice service rep and updated my insurance to BCBS (since my last supply order was in December). So, she said she had to call and verify coverage (and I secretly shuttered thinking "Oh, great, another insurance debacle). So, for my own ANNOYED amusement, I asked if there was any payment showing for my pump in August or the supply order from December and the woman looked........... paused (probably stunned) and said "No, ma'am, nothing is paid for." Lovely. So, I was pissed at this point and called my assigned rep "Fernando". He sounded guarded when he heard me. He explained that the "process" was still happening with billing. I told him I wanted to talk to someone in billing, then. He was hesitant ( as I believe billing unloaded me on poor Fernando at some point). He tried to connect me and, ironically, no one was there. When he came back on the line, I asked what we were waiting for........GreatWest had told me in November and January that it was not "medically necessary" and why couldn't the default to my secondary UHC insurance at this point (since they had agreed to cover it 80/20). I explained that I don't want to indefinitely be racking up 20% charges on my orders and letting it go one indefinitely with a whopping bill waiting at the end. I also reminded Fernando that I've been through this now with him since December. He was frustrated and referred me back to billing------I actually got a voicemail, but now one that identified the woman on the other end, but I still left a terse message.

I then took matters into my own hands and called GreatWest asking them if they've made final appeal decisions. i've been blaming the insurance company all along, but I'll admit I was wrong. They were able to tell me that they did not receive the full medical notice and appeal from Omnipod until February 26th and it takes 30-45 days for the appeal process.

CAN SOMEONE EXPLAIN TO ME WHAT OMNIPOD WAS DOING FROM 12/11/07-2/26/08 SINCE I HAD FAXED THEM THE DENIAL LETTER FROM GREATWEST ON 12/11/07 AND AGAIN IN LATE JANUARY??????????

Late afternoon yesterday I received two phone calls from Omnipod. The first one was from the order department stating that BCBS was going to cover my supplies at 100%, WOW. That's cool. The other phone call was the rep from Omnipod saying the paperwork wasn't processed immediately, but they did file it 2/26. At least she was honest. So, I'll have to wait until the appeal process is over.

Moral of the story: stay on top of medical companies and read everything you can about insurance coverage!!!