Diabetes Self-Management Blog

Note: The names have been changed to protect the innocent corporate and insurance interests in this piece. Also, as of this writing, Eric has yet to find out if his situation has been resolved.

Dear Care Coordinator:

Early this evening on my drive home from work, I received a phone call from someone in your office. This woman told me that my insurance plan doesn’t cover my durable medical equipment supplies from your company, Medical Equipment One, and that I’ll have to go with Another Company, Inc., for my insurance to cover my supplies.

Care Coordinator, this is all the information I received from this woman. No, wait…that’s not true. She also gave me the phone number for Another Company, Inc., to try to be helpful. I called Another Company immediately, but because it was after 5:00 PM, there was no one to take my call. I’m going to have to wait and call them tomorrow morning and go through the whole process of getting another supplier tomorrow.

I’m curious about several things:

1. Why was my previous shipment of medical supplies for my Type 1 diabetes (insulin pump supplies, test strips, lancets, and so on) sent to me in early February from your company without any mention of my insurance being unable to cover it? My employer switched insurance carriers effective January 1 of this year, so I don’t understand the five-month lag. The past three months have been pretty peachy, but it appears as if I was sitting on a medical supplies time bomb.

2. The frustrating—well, one of the frustrating—things about this situation is that last week you called to tell me that my supplies would be shipping this week and then called me this afternoon to let me know that my supplies were going out the door today. But then I get the phone call on my drive home to inform me otherwise—and at a time when no one is open and I have no way to contact them to try to figure out what’s going on. And, so, here I am, anxious about what’s going to happen and assuming that tomorrow morning I’ll spend hours on the phone trying to figure out how to get on with Another Company and expedite the process of having my medical supplies shipped so that I’ll get the things I need in the short window left before several of my diabetes items run out.

3. Oh, which brings me to this: Why I wasn’t told earlier about this mix-up in your continuing to keep me as a client? Wouldn’t it have been possible to give me more than a day to find another durable medical equipment provider? Five days before I need new test strips and infusion sets is not a whole lot of time to get everything squared away with Another Company. Not in my experience. I mean, really, it can’t be the case that I’m the only customer you guys have whose insurance provider is Major University Health Care.

4. Who paid for my first shipment of medical supplies if, as this woman told me, it wasn’t covered by my insurance? The woman on the phone said something about an unpaid balance on my account, which was news to me. If this is the case, then I anticipate even more time on the phone with insurance and billing and on and on with appeals and, well…boy, that’s an exciting prospect!

5. How did this happen in the first place? (Wait, see question 3 again.) I’m frustrated because in the past year I’ve gone through this with three different medical suppliers, and it’s getting old—especially when I have to triage the situation last-minute by spending an entire morning making phone calls because information was withheld or the customer service/communication was poor.

I’m not placing blame directly on you, Care Coordinator. You were more than helpful with the first shipment, and I was happy with the level of customer service last week when you called me and let me know that the shipment was going to be coming my way this week; and then again I was happy with the customer service on Tuesday when you called and said the supplies were going to be shipping out Tuesday evening. But of course all of that customer service becomes moot if the internal communication at Medical Equipment One is such that I’m covered at lunch and not covered by dinner.

If there’s someone there with whom I can speak so I can get a more clear answer about this, do let me know. I thought that after going through a pretty miserable runaround with Old Medical Equipment Supplier last year, finally, my supplier woes were behind me with Medical Equipment One. But then the supplies rug gets pulled out from underneath me with so little time left to get things straightened out before I need a new shipment.

Sincerely,
Eric Lagergren

Follow-up note: Eric has found out that the phone call he received on his drive home on Tuesday was in fact misinformation given to him by the woman who called him from Medical Equipment One. As of Wednesday, April 30, Medical Equipment One was checking into the situation, and they promised him that they’d ship the materials as soon as they could and that they’d call him to let him know everything was on its way. Eric, however, doesn’t yet know if everything is on its way.

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Comments
  1. i hate dealing with ‘durable equipment providers’. it is just as bad as dealing with ‘insurance providers’. i bet lobbyists hired by these equipment providers keep diabetes from being cured. but maybe i’m paranoid.

    Posted by chaddiabetic |
  2. Did you contact your insurance company to see who they were contracted with for Durable Medical Supplies? If you contacted them and they said that Medical Equipment One was covered then I would give the grief to the insurance company and find out why that is not true any more. As a consumer you need to be very much aware of what is covered by your plan and what is not covered. Don’t expect the provider of service to know. Too many people do not understand their insurance plans and what is covered. They don’t know the difference between deductible, coinsurance and copays. When they get hit with a hugh unexpected bill, it is too late to do the research. Ask ahead of time.

    Posted by Office Manager |
  3. In January, I had foot surgery to remove a toe. I needed a knee-boot to off-load the pressure during recovery. My insurance (PacificCare) paid for the boot, but NOT for the padded insert that accompanmied it. WHY!?!? You figure it out!! I’ve never been drunk enough to understand their logic.

    Posted by B. Alan Thompson |
  4. THIS is exactly the reason I prefer to deal with a company who has a local office! I was with one of those, who sold their client list to a National Company. I let them send the first shipment because I wasn’t notified of the switch until the last minute…. then I found a different local provider and switched myself.

    I LIKE being able to walk into their office to straighten out any problems. I think it is much easier to get glitches solved if they are looking me in the eyes!

    Eric, I suggest part of your phone time be spent calling to see who LOCALLY can provide you with your supplies.

    Posted by Ephrenia |
  5. The whole online medical supply/epharmacy topic is tricky. Most of these companies don’t give lick about their customers… they just care about people clicking the right buttons. I will only give my business to companies that place a high priority on Customer Service. There are good companies out there. The best one I know of is Home Delivery Medical. I’ve found their Customer Service Agents to be friendly, helpful, respectful, and knowledgeable. If you buy medical supply they’re certainly worth trying out. They also do Medicare, Medicaid, and secondary insurance billing.

    Cheers

    Posted by Dan |
  6. My father is in assisted living and even the place he’s at seems to change contracts once a year on where they get the medical supplies delivered from . It makes it difficult and I completely understand your frustration with diabetic supplies. His his testing strips used to be free but then I switched his payment method backup as my credit card to “make things easier” and now my visa is getting charge $59 a pop for his 50 pack of lancet strips. Not looking forward to getting on the phone to take care of this nightmare.

    I believe the system is broken and needs to be fixed.

    Leslie
    JRS Medical

    Posted by Leslie |
  7. Every Insurance company is different,with different payment rules. It is the responsibility, as well, of the insured to figure out what is covered. Could you imagine the time it would take to call every clients insurtance company to ensure that the product ordered by the physician is a covered item? I know an average call to an insurance company can take over a half hour. I’m sure that would make you happy as the client, to wait every time you need medical supplies to see IF that item is covered…..So…. the DME provider gives you the supplies in good faith that your insurance policy will cover something as standard as diabetic supplies. But lets say for some reason, that diabetic supplies are not covered under your plan, so now the DME supplier you chose gets to “eat” the costs of your strips and supplies that you used? Because they were trying to help. take responsibility for your healthcare, don’t expect the DME company to know YOUR policy. please.

    Posted by jennifer |
  8. Eric,

    Even though I’m now just reading this more than a few years later, it ticks me off when you mentioned that this is your 3RD medical equipment company you had gone through at the time. Unfortunately, I’ve realized over time that this industry has a bad reputation for crap service (even if Customer Care lady wasn’t bad), so I wouldn’t be surprised if a new Virgin-esque company enters the market sometime soon.

    Well, anyways, hope all is well now in 2013 - keep writing and killing it with the site!

    -Jon Cooper

    Posted by Jon Cooper |
  9. I am working at a DME. I can tell you this will get even worse. Medicare has lowered pricing thru a bogus Competitive Bidding Program that leading economist say is a “Train Wreck”. These providers have always gotten a bad rap. There have been some that have been caught doing some illegal billing, but understand, this is very few.. The hoops that DME’s have to jump thru to get paid are incredible. The “local Companies” will be virtually non existent in the near future. Diabetic supplies will be handle by National Companies starting in July 2013. Please remember that pricing is dictated by Medicare and Medicaid. The DME’s DO NOT set the pricing on reimbursable items.

    -T. Butler

    Posted by T. Butler |

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